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NPI Code Detail

MEDICARE: DAVID COOKSEY MD

MEDICARE: DAVID COOKSEY 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
1207N00000XDermatology Physician012189LA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2070004786OTHERLARAILROAD MEDICARE NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31053315846OTHERLAGROUP NPI NUMBER

General Provider Information

NPI Number : 1225032121
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID COOKSEY MD
Provider Business Mailing Address
First Line : 1455 E BERT KOUNS LOOP
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-5634
Country : US
Telephone Number : 318-798-4677
Fax Number : 318-798-4417
Provider Business Practice Location Address
First Line : 1455 E BERT KOUNS LOOP
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-5634
Country : US
Telephone Number : 318-798-4677
Fax Number : 318-798-4417
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 01/12/2009

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Directions to “ DAVID COOKSEY MD” Practice Location

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