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General NPI Number Information
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NPI Number | 1669625000
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Entity Type | Organization
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Legal Business Name | WILLIAM S COOK JR M D P A
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 10/29/2008
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Provider Practice Location Address
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Address Line | 2906 N STATE ST
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City | JACKSON
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State | MS
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Zip | 39216-4233
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Country | US
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Telephone | 601-366-3660
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Fax |
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Provider Business Mailing Address
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Address Line | 2906 N STATE ST
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City | JACKSON
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State | MS
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Zip | 39216-4233
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Country | US
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Telephone | 601-366-3660
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM S COOK JR.
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Credential |
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Telephone | 601-366-3660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 10170
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License Number State | MS
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