Provider Demographics
NPI:1861572075
Name:COCHRAN, JOHN L (OD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:L
Last Name:COCHRAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:13320 FRANKLIN FARM RD STE H
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-4097
Mailing Address - Country:US
Mailing Address - Phone:703-481-5600
Mailing Address - Fax:703-437-4137
Practice Address - Street 1:13320 FRANKLIN FARM RD STE H
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-4097
Practice Address - Country:US
Practice Address - Phone:703-481-5600
Practice Address - Fax:703-437-4137
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0618000381152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAAP4203OtherDAVIS VISION
VA178389OtherANTHEM
VA2129615OtherMAMSI
VAVA0922OtherEYEMED
VA09721OtherSPECTERA
VA12436OtherAVESIS
VA4609512OtherAETNA PPO
VAG9450001OtherCARE FIRST
VA0009237666Medicaid
VA487204OtherNVA
VAVA00922OtherVBA
VA1519001OtherCIGNA
VA12436OtherAVESIS
VA4609512OtherAETNA PPO