Provider Demographics
NPI:1467404319
Name:COCHRAN, WILLIAM MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MICHAEL
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 1:4050 N CIRCULO MANZANILLO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-1879
Mailing Address - Country:US
Mailing Address - Phone:520-989-3521
Mailing Address - Fax:520-989-3522
Practice Address - Street 1:140 W DUVAL MINE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-5000
Practice Address - Country:US
Practice Address - Phone:520-989-3521
Practice Address - Fax:520-989-3522
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15469208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
1003085937OtherTYPE 2, GROUP NPI
AZ15469OtherSTATE MEDICAL LICENSE
AZZ106543OtherGRP PIN-BILLING PROVIDER#
AZZ106726Medicare PIN
1003085937OtherTYPE 2, GROUP NPI