MEDICARE: KIM COOK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0901X	Public Health & General Preventive Medicine Physician	34322	GA

General Provider Information

NPI Number	:	1104710185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM COOK MD

Provider Business Mailing Address
First Line	:	201 2ND ST STE 1100
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31201-6328
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	98 COHEN WALKER DR
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-2729
Country	:	US
Telephone Number	:	478-218-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2025
Last Update Date	:	06/05/2025

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Directions to “ KIM COOK MD” Practice Location

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