Healthcare Provider Details

I. General information

NPI: 1700801164
Provider Name (Legal Business Name): SHARON ANN COOK R, MR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 E RACE AVE
SEARCY AR
72143-4725
US

IV. Provider business mailing address

127 FOXDELL CIR
JACKSONVILLE AR
72076-2608
US

V. Phone/Fax

Practice location:
  • Phone: 501-368-0653
  • Fax: 501-368-0658
Mailing address:
  • Phone: 501-985-9777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License NumberRTL6339
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number206841
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: