Individual
COURTNEY JANE COCKERELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
1011 BOWLES AVE STE 425, FENTON, MO 63026-2384
(636) 496-5030
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-1840
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2015021511
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/02/2012
Last updated
10/20/2020
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