MEDICARE: JOE CHRISTOPHER COOK I MD, M.P.H., A.T.C

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	2255A2300X	Athletic Trainer	AT0272	MS
2	208VP0000X	Pain Medicine Physician	22851	MS
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	22851	MS

General Provider Information

NPI Number	:	1285663633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOE CHRISTOPHER COOK I MD, M.P.H., A.T.C

Provider Business Mailing Address
First Line	:	PO BOX 649113
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75264-9113
Country	:	US
Telephone Number	:	855-343-5763
Fax Number	:	855-343-5763

Provider Business Practice Location Address
First Line	:	114 BYRAM BUSINESS CENTER DR
Second Line	:
City	:	BYRAM
State	:	MS
Zip	:	39272-9636
Country	:	US
Telephone Number	:	601-376-9960
Fax Number	:	601-376-4676

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	06/25/2025

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