MEDICARE: DR. SHON WILLIAM 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	207T00000X	Neurological Surgery Physician	22474	ND
2	207T00000X	Neurological Surgery Physician	24168	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00213656	OTHER	OK	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1629060660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHON WILLIAM COOK MD

Provider Business Mailing Address
First Line	:	5301 WHITE FENCES
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73131-6603
Country	:	US
Telephone Number	:	405-308-7482
Fax Number	:	405-701-5006

Provider Business Practice Location Address
First Line	:	10001 S WESTERN AVE STE 101
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2993
Country	:	US
Telephone Number	:	405-310-6977
Fax Number	:	405-701-5006

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	05/26/2026

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Directions to “ DR. SHON WILLIAM COOK MD” Practice Location

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