Provider Demographics
NPI:1326780206
Name:COCHRAN, JAMES TYLER
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:TYLER
Last Name:COCHRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 EVERGREEN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TAMASSEE
Mailing Address - State:SC
Mailing Address - Zip Code:29686-2111
Mailing Address - Country:US
Mailing Address - Phone:864-901-5903
Mailing Address - Fax:
Practice Address - Street 1:1514 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2429
Practice Address - Country:US
Practice Address - Phone:504-842-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program