Healthcare Provider Details
I. General information
NPI: 1548054075
Provider Name (Legal Business Name): VALCORE RESOURCE, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/08/2025
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 E MAIN ST
NEW ALBANY IN
47150-5827
US
IV. Provider business mailing address
600 E MAIN ST
NEW ALBANY IN
47150-5827
US
V. Phone/Fax
- Phone: 502-554-3191
- Fax:
- Phone: 502-554-3191
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084A0401X |
| Taxonomy | Addiction Medicine (Psychiatry & Neurology) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
E
COOKE
Title or Position: PRESIDENT
Credential: MD
Phone: 812-252-9020