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General NPI Number Information
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NPI Number | 1356440721
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Entity Type | Individual
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Provider Name | WILLIAM S COOK JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 10/13/2016
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Provider Practice Location Address
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Address Line | 4500 I 55 N STE 256
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City | JACKSON
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State | MS
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Zip | 39211-5930
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Country | US
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Telephone | 601-366-3660
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Fax | 601-366-0636
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Provider Business Mailing Address
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Address Line | 4500 I 55 N STE 256
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City | JACKSON
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State | MS
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Zip | 39211-5930
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Country | US
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Telephone | 601-366-3660
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Fax | 601-366-0636
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | 10170
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License Number State | MS
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