MEDICARE: DR. BRIGGS E. COOK JR. M.D.

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	152WC0802X	Corneal and Contact Management Optometrist	200100337	NC
2	207W00000X	Ophthalmology Physician	2001-00337	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457317976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIGGS E. COOK JR. M.D.

Provider Business Mailing Address
First Line	:	10210 HICKORYWOOD HILL AVE
Second Line	:	SUITE 200
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-3332
Country	:	US
Telephone Number	:	704-450-7563
Fax Number	:

Provider Business Practice Location Address
First Line	:	10210 HICKORYWOOD HILL AVE
Second Line	:	SUITE 200
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-3332
Country	:	US
Telephone Number	:	704-450-7563
Fax Number	:

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

Provider Enumeration Date	:	04/24/2006
Last Update Date	:	01/23/2015

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