Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 34004160 | OH |
NPI | 1144285131 |
---|---|
Provider Name | Dr. Jeffrey Martin Cochran |
First Address | Massillon, OH 44646-3616 |
Second Address | Massillon, OH 44646-3616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0817772 | (05) | OH |
E76654 | (02) | OH |