Individual
DR. CARL C COTTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
820 COBURN AVE, WORLAND, WY 82401-3317
(307) 347-6141
(307) 347-6142
Mailing address
PO BOX 2, WORLAND, WY 82401-0002
(307) 347-6141
(307) 347-6142
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
255T
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134451-00
—
WY
01
—
307683
BLUECROSS BLUE SHIELD
WY
05
—
307683
—
WY
05
—
9200460
—
SD
Enumeration date
06/13/2006
Last updated
12/08/2020
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