Provider Demographics
NPI:1336137140
Name:COCHRAN, SCOTT D (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
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 1:4140 SE ADAMS RD
Mailing Address - Street 2:#103
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-8450
Mailing Address - Country:US
Mailing Address - Phone:918-214-8232
Mailing Address - Fax:918-214-8237
Practice Address - Street 1:4140 SE ADAMS RD
Practice Address - Street 2:#103
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-8450
Practice Address - Country:US
Practice Address - Phone:918-214-8232
Practice Address - Fax:918-214-8237
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK17416207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100194630AMedicaid
OK731504061OtherAETNA
C14577Medicare UPIN
OK367504YPF1Medicare PIN