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General NPI Number Information
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NPI Number | 1538216338
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Entity Type | Individual
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Provider Name | ZANDRAETTA L TIMS-COOK MD, MPH
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Gender | Female
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 02/12/2023
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Provider Practice Location Address
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Address Line | 2193 CASCADE RD SW
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City | ATLANTA
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State | GA
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Zip | 30311-2862
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Country | US
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Telephone | 844-884-9691
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Fax | 404-907-4052
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Provider Business Mailing Address
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Address Line | 3939 LAVISTA RD # 310
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City | TUCKER
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State | GA
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Zip | 30084-5162
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Country | US
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Telephone | 844-884-9691
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Fax | 404-907-4052
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 63616
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 63616
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License Number State | GA
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