Individual
DR. JESSICA D BOCOOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
906 N HOWE ST, SOUTHPORT, NC 28461
(910) 454-1197
(910) 454-4330
Mailing address
924 N HOWE ST, SOUTHPORT, NC 28461-3038
(910) 457-3806
(910) 457-3842
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
2010-00929
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64120751
—
KY
Enumeration date
07/28/2006
Last updated
02/19/2019
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