Caleb Michael Cochran
Individual provider Active NPI Counselor · Atoka, OK
NPI 1346587029 · NPPES record last updated Jan 15, 2013
Key facts
- NPI
- 1346587029
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 1410 S. Gin Rd.
Atoka, OK 74525-1633 - Phone
- (580) 364-4424
- NPI assigned
- Jan 15, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
1410 S. Gin Rd.
Atoka, OK 74525-1633
Mailing address
405 N Linda Ave
Atoka, OK 74525-1633
Phone (580) 239-0304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200287120A | Medicaid | OK |
Other providers in Atoka, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.