Individual
CLARENCE E COKER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 E HOSPITAL ST STE 3, MANNING, SC 29102-3149
(803) 435-8828
(803) 435-2239
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(803) 435-5270
(803) 433-0154
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5059
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
050599
—
SC
01
—
7602
MEDICARE GROUP
SC
Enumeration date
02/09/2006
Last updated
03/31/2021
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