Provider Demographics
NPI:1598799850
Name:COOK, WILLIAM HAYMOND (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:HAYMOND
Last Name:COOK
Suffix:
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 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:334-747-4159
Mailing Address - Fax:
Practice Address - Street 1:2055 E SOUTH BLVD STE 603
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2014
Practice Address - Country:US
Practice Address - Phone:334-747-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35081563C208600000X, 208G00000X
KY37727208600000X, 208G00000X
AL26039208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000239939OtherANTHEM
OH2363517Medicaid
1800451OtherUNITED HEALTHCARE
81563OtherCHOICE CARE/HUMANA
H71795Medicare UPIN
OH4093791Medicare PIN
1800451OtherUNITED HEALTHCARE
81563OtherCHOICE CARE/HUMANA
KY0677813Medicare PIN
OH4093791Medicare ID - Type UnspecifiedOH MEDICARE