Richard I. Cocke Jr., P.s.c. | |
41 Industrial Pwy Calvert City KY 42029 | |
(270) 395-4349 | |
(270) 395-0175 |
Full Name | Richard I. Cocke Jr., P.s.c. |
---|---|
Speciality | Dentist |
Location | 41 Industrial Pwy, Calvert City, Kentucky |
Authorized Official Name and Position | Richard Ivanhoe Cocke (PRESIDENT) |
Authorized Official Contact | 2703954349 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Richard I. Cocke Jr., P.s.c. 41 Industrial Pwy P.o. Box 625 Calvert City KY 42029 Ph: (270) 395-4349 | Richard I. Cocke Jr., P.s.c. 41 Industrial Pwy Calvert City KY 42029 Ph: (270) 395-4349 |
NPI Number | 1912049636 |
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Provider Enumeration Date | 02/12/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912049636 | NPI | - | NPPES |
60051273 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 5127 (Kentucky) | Primary |