Provider Demographics
NPI:1417050568
Name:COCHRAN, RICHARD K (MD FCAP)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:K
Last Name:COCHRAN
Suffix:
Gender:M
Credentials:MD FCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 403751
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384
Mailing Address - Country:US
Mailing Address - Phone:602-424-1580
Mailing Address - Fax:602-424-1581
Practice Address - Street 1:1700 N. DESERT DRIVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281
Practice Address - Country:US
Practice Address - Phone:602-424-1580
Practice Address - Fax:602-424-1581
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28181207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0110667OtherGHI
A15994Medicare UPIN