Individual
GARY WILLIAM COCKRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
785 OLD HICKORY BLVD, SUITE 101, BRENTWOOD, TN 37027-4512
(615) 370-8880
(615) 370-9039
Mailing address
785 OLD HICKORY BLVD, SUITE 101, BRENTWOOD, TN 37027-4512
(615) 370-8880
(615) 370-9039
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
DPM0000000353
TN
213ES0131X
Foot Surgery Podiatrist
Primary
DPM0000000353
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
621451791
FEDERAL EMPLOYER TAX ID #
TN
Enumeration date
02/09/2007
Last updated
06/04/2013
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