MEDICARE: DR. ROBERT L COCKROFT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	6129	TN

General Provider Information

NPI Number	:	1578566741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT L COCKROFT MD

Provider Business Mailing Address
First Line	:	2683 FOREST HILL IRENE RD
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38139-7805
Country	:	US
Telephone Number	:	901-336-1401
Fax Number	:

Provider Business Practice Location Address
First Line	:	2683 FOREST HILL IRENE RD
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38139-7805
Country	:	US
Telephone Number	:	901-336-1401
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	11/03/2014

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