MEDICARE: JAMES S 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	207Q00000X	Family Medicine Physician	0101032900	VA

General Provider Information

NPI Number	:	1487743100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES S COOK MD

Provider Business Mailing Address
First Line	:	2105 E PARHAM RD
Second Line	:	SUITE 109
City	:	RICHMOND
State	:	VA
Zip	:	23228
Country	:	US
Telephone Number	:	804-762-9646
Fax Number	:	804-762-4754

Provider Business Practice Location Address
First Line	:	2105 E PARHAM RD
Second Line	:	SUITE 109
City	:	RICHMOND
State	:	VA
Zip	:	23228
Country	:	US
Telephone Number	:	804-762-9646
Fax Number	:	804-762-4754

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	07/08/2007

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