Healthcare Provider Details

I. General information

NPI: 1225162472
Provider Name (Legal Business Name): RICHARD LYN-COOK MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3493 VETERANS DR N STE C
HUNTINGDON TN
38344-6230
US

IV. Provider business mailing address

2380 S MACGREGOR WAY APT 256
HOUSTON TX
77021-1179
US

V. Phone/Fax

Practice location:
  • Phone: 731-986-2933
  • Fax: 731-986-2938
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number219372
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM6734
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number62927
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number219372
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number62927
License Number StateTN
# 6
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD62927
License Number StateTN
# 7
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM6734
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: