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Individual
WILEY T. COCKRELL JR.
Active
Individual
WILEY T. COCKRELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
38915
NC
207Q00000X
Family Medicine Physician
Primary
38915
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23204
BCBS PROVIDER NUMBER
NC
05
—
8923204
—
NC
Enumeration date
09/06/2006
Last updated
11/20/2012
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