Provider Demographics
NPI:1356440721
Name:COOK, WILLIAM S JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:COOK
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:4500 I 55 N
Mailing Address - Street 2:STE 256
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-5930
Mailing Address - Country:US
Mailing Address - Phone:601-366-3660
Mailing Address - Fax:601-366-0636
Practice Address - Street 1:4500 I 55 N
Practice Address - Street 2:STE 256
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-5930
Practice Address - Country:US
Practice Address - Phone:601-366-3660
Practice Address - Fax:601-366-0636
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2016-10-13
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Provider Licenses
StateLicense IDTaxonomies
MS101702084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS260000293Medicare ID - Type Unspecified