Provider Demographics
NPI:1598749202
Name:COCHRANE, J ALAN (MD)
Entity Type:Individual
Prefix:
First Name:J
Middle Name:ALAN
Last Name:COCHRANE
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 1:5221 US ROUTE 60 E
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-2022
Mailing Address - Country:US
Mailing Address - Phone:304-522-1550
Mailing Address - Fax:304-522-1073
Practice Address - Street 1:5221 US ROUTE 60 E
Practice Address - Street 2:RADIOLOGY INC
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-2022
Practice Address - Country:US
Practice Address - Phone:304-522-1550
Practice Address - Fax:304-522-0704
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV118612085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0118173000Medicaid
OH0775264Medicaid
WV300021813OtherRAILROAD MEDICARE
WV55049337600OtherWORKMANS COMP
OH00000065734OtherUNISON
001718768OtherMTN STATE BCBS
4322922OtherAETNA
KY50007241OtherPASSPORT
KY6469940800Medicaid
KY6469940800Medicaid
001718768OtherMTN STATE BCBS