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Individual

CARA C COCKERILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
404 W FOUNTAIN ST, ALBERT LEA, MN 56007-2437
(507) 373-2384
Mailing address
404 W FOUNTAIN ST, ALBERT LEA, MN 56007-2437
(507) 373-2384

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
55249
MN
207Y00000X
Otolaryngology Physician
74068
WI
207Y00000X
Otolaryngology Physician
Primary
Q7851
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ENROLLED
IA
05
ENROLLED
MN
Enumeration date
06/17/2011
Last updated
11/13/2024
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