Provider Demographics
NPI:1457317976
Name:COOK, BRIGGS E JR (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIGGS
Middle Name:E
Last Name:COOK
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10210 HICKORYWOOD HILL AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-3332
Mailing Address - Country:US
Mailing Address - Phone:704-450-7563
Mailing Address - Fax:
Practice Address - Street 1:10210 HICKORYWOOD HILL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3332
Practice Address - Country:US
Practice Address - Phone:704-450-7563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100337152WC0802X
NC2001-00337207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89129WFMedicaid
NCG30878Medicare UPIN
NC89129WFMedicaid