| Cockrell Family Medical Center Pc | |
|
120 Norfleet Dr Senatobia MS 38668-2220 | |
| (662) 301-1128 | |
| (662) 301-4430 |
| Full Name | Cockrell Family Medical Center Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 Norfleet Dr, Senatobia, Mississippi |
| Authorized Official Name and Position | Jessie Michael Cockrell (PRESIDENT) |
| Authorized Official Contact | 6623011128 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cockrell Family Medical Center Pc 120 Norfleet Dr Senatobia MS 38668-2220 Ph: (662) 301-1128 | Cockrell Family Medical Center Pc 120 Norfleet Dr Senatobia MS 38668-2220 Ph: (662) 301-1128 |
| NPI Number | 1497705446 |
|---|---|
| Provider Enumeration Date | 05/11/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7517954167 |
|---|---|
| Medicare Enrollment ID | O20040427000809 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497705446 | NPI | - | NPPES |
| DE7710 | Other | MS | GROUP MS RAILROAD MEDICAR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | M17248 (Mississippi) | Primary |
| Provider Name | Anna M Meyers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932115094 PECOS PAC ID: 2163427048 Enrollment ID: I20060927000524 |
| Provider Name | Jessie M Cockrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285639302 PECOS PAC ID: 6305833955 Enrollment ID: I20110407000412 |
| Provider Name | Kathryn Alred |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710619622 PECOS PAC ID: 4688058472 Enrollment ID: I20220829000032 |
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