Provider Demographics
NPI:1376675074
Name:COOKSEY HARRINGTON, ERIN (MD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:COOKSEY HARRINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:COOKSEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2000 E GREENVILLE ST
Mailing Address - Street 2:SUITE #1600
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1580
Mailing Address - Country:US
Mailing Address - Phone:864-226-9193
Mailing Address - Fax:864-231-0281
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:SUITE #1600
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-226-9193
Practice Address - Fax:864-716-6732
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22735207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC227356Medicaid
SCH941414871Medicare ID - Type Unspecified
SC227356Medicaid