| 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 |
|---|---|
| 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 |
|---|---|
| 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 |