Basic Information
| Provider Information | |||||||||
| NPI: | 1568401610 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COCHRAN | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 856 J CLYDE MORRIS BLVD STE A | ||||||||
| Address2: | |||||||||
| City: | NEWPORT NEWS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 236011318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7573165800 | ||||||||
| FaxNumber: | 7575345190 | ||||||||
| Practice Location | |||||||||
| Address1: | 17385 LANKFORD HWY | ||||||||
| Address2: | |||||||||
| City: | PARKSLEY | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7576655996 | ||||||||
| FaxNumber: | 7576655973 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 06/05/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS010113L | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 0102202590 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.