Cockram, Bobby Lewis

Cockram, Bobby Lewis is an individual health care provider with primary practice located at 3300 Gallows Rd , Falls Church VA 22042-3300. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Cockram, Bobby Lewis can be contacted via phone (703) 776-4001.

Contact Information

Primary practice address
3300 Gallows Rd Falls Church VA 22042-3300
Phone: (703) 776-4001
Fax: (703) 776-7113
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 0110001402 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110001402 Virginia

Profile Details

NPI number 1689601320
LBN Legal business name Cockram, Bobby Lewis
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Sep 22nd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689601320 NPPES
Virginia Other P00679650 MEDICARE RAILROAD
Virginia MEDICAID 1689601320 MEDICARE RAILROAD
Virginia Other P00453916 MEDICARE RAILROAD
Virginia MEDICAID 010392055 MEDICARE RAILROAD

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