Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 0066934 | CO |
N | 2080P0204X | Pediatric Emergency Doctor | 35091186 | OH |
NPI | 1225291461 |
---|---|
Provider Name | Dr. Sandra Patrice Spencer Cockerham |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2008 |
Last Update Date | 18/01/2022 |