Healthcare Provider Details

I. General information

NPI: 1629060660
Provider Name (Legal Business Name): SHON WILLIAM COOK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W TECUMSEH RD
NORMAN OK
73072
US

IV. Provider business mailing address

PO BOX 720365
NORMAN OK
73070-4270
US

V. Phone/Fax

Practice location:
  • Phone: 405-310-6977
  • Fax:
Mailing address:
  • Phone: 405-292-5500
  • Fax: 405-292-5505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number22474
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number24168
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: