Organization
COCKRELL FAMILY MEDICAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE MICHAEL COCKRELL MD (PRESIDENT)
(662) 301-1128
Entity
Organization
Contact information
Practice address
120 NORFLEET DR, SENATOBIA, MS 38668-2220
(662) 301-1128
(662) 301-4430
Mailing address
120 NORFLEET DR, SENATOBIA, MS 38668-2220
(662) 301-1128
(662) 301-4430
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
M17248
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE7710
GROUP MS RAILROAD MEDICAR
MS
Enumeration date
05/11/2006
Last updated
08/22/2020
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