Individual
DR. DOUGLAS SCOTT COCKRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD, RPH
Contact information
Practice address
2206 STATE ST, CHESTER, IL 62233-1142
(618) 826-4898
(618) 826-3751
Mailing address
3774 STATE ROUTE 4, MARISSA, IL 62257-2902
(618) 979-3182
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051288811
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051288811
STATE LICENSE
IL
Enumeration date
11/26/2017
Last updated
11/26/2017
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