Healthcare Provider Details

I. General information

NPI: 1841293008
Provider Name (Legal Business Name): CHRISTOPHER L COOK PHARM.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 SUNSET DR STE 102
ATHENS GA
30606-2287
US

IV. Provider business mailing address

145 WESLEY DR
ATHENS GA
30605-7052
US

V. Phone/Fax

Practice location:
  • Phone: 706-369-0301
  • Fax:
Mailing address:
  • Phone: 706-552-0406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number018489
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: