| 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 |