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General NPI Number Information
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NPI Number | 1417166489
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Entity Type | Organization
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Legal Business Name | JOEL M. COOK, DPM, PA
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 03/05/2013
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Provider Practice Location Address
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Address Line | 5677 S REX RD
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City | MEMPHIS
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State | TN
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Zip | 38119-3821
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Country | US
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Telephone | 901-818-2727
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Fax | 901-818-2737
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Provider Business Mailing Address
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Address Line | 5677 S REX RD
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City | MEMPHIS
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State | TN
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Zip | 38119-3821
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Country | US
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Telephone | 901-818-2727
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Fax | 901-818-2737
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOEL MARTIN COOK
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Credential | D.P.M.
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Telephone | 901-818-2727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | DPM0000000119
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License Number State | TN
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