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General NPI Number Information
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NPI Number | 1912984196
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Entity Type | Organization
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Legal Business Name | MEDICAL SPECIALISTS OF COOKEVILLE, PLLC
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 128 N WHITNEY AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-2450
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Country | US
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Telephone | 931-528-7662
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Fax | 931-528-1266
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Provider Business Mailing Address
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Address Line | 128 N WHITNEY AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-2450
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Country | US
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Telephone | 931-528-7662
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Fax | 931-528-1266
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | CHERYL M MYERS
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Credential |
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Telephone | 931-528-7662
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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 | 020230
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 33892
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 38941
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 6496
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 13543
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 7522
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License Number State | TN
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