Provider Demographics
NPI:1720088891
Name:SHARPE DILLON COCKSON & ASSOCIATES PA
Entity Type:Organization
Organization Name:SHARPE DILLON COCKSON & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHARPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:952-926-2300
Mailing Address - Street 1:7250 FRANCE AVE S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4305
Mailing Address - Country:US
Mailing Address - Phone:952-926-2300
Mailing Address - Fax:952-926-7385
Practice Address - Street 1:7250 FRANCE AVE S
Practice Address - Street 2:SUITE 100
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4305
Practice Address - Country:US
Practice Address - Phone:952-926-2300
Practice Address - Fax:952-926-7385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN24852207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNCD5217OtherRAILROAD MEDICARE
MN02130SHOtherBLUE CROSS BLUE SHIELD MN
MN55435A001OtherTRICARE
MNNA318OtherPREFERRED ONE
MN9804297OtherMEDICA
MNNA318OtherPREFERRED ONE