Provider Demographics
NPI:1205857711
Name:COCHRAN, ROBERT BRUCE (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRUCE
Last Name:COCHRAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WESTMINSTER ST
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:NH
Mailing Address - Zip Code:03608-0758
Mailing Address - Country:US
Mailing Address - Phone:603-756-3960
Mailing Address - Fax:
Practice Address - Street 1:11 WESTMINSTER ST
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:NH
Practice Address - Zip Code:03608
Practice Address - Country:US
Practice Address - Phone:603-756-3960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6917207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH00000035Medicaid
E12730Medicare UPIN
NH00000035Medicaid