Healthcare Provider Details

I. General information

NPI: 1104036920
Provider Name (Legal Business Name): SHON COOK MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W TECUMSEH RD SUITE 304
NORMAN OK
73072-1810
US

IV. Provider business mailing address

PO BOX 720365
NORMAN OK
73070-4270
US

V. Phone/Fax

Practice location:
  • Phone: 405-310-6977
  • Fax: 405-292-5505
Mailing address:
  • Phone: 405-310-6977
  • Fax: 405-292-5505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number24168
License Number StateOK

VIII. Authorized Official

Name: SHON W COOK
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 405-310-6977