Provider Demographics
NPI:1003006032
Name:LANE M. COOK, M.D.
Entity Type:Organization
Organization Name:LANE M. COOK, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LANE
Authorized Official - Middle Name:MARSHALL
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-588-6425
Mailing Address - Street 1:PO BOX 10187
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37939-0187
Mailing Address - Country:US
Mailing Address - Phone:865-588-6425
Mailing Address - Fax:865-584-8066
Practice Address - Street 1:4428 SUTHERLAND AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5008
Practice Address - Country:US
Practice Address - Phone:865-588-6425
Practice Address - Fax:865-584-8066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0147482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty