Individual
GILAN L COCKRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD FAAO
Contact information
Practice address
512 COMMERCIAL ST, EMPORIA, KS 66801-4006
(620) 343-7120
(620) 343-2038
Mailing address
512 COMMERCIAL ST, EMPORIA, KS 66801-4006
(620) 343-7120
(620) 343-2038
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11473
KS
152W00000X
Optometrist
2183
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100217850A
—
KS
01
—
410001132
RAILROAD MEDICARE
KS
01
—
632550001
DMERC
KS
Enumeration date
01/05/2006
Last updated
09/24/2009
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