Provider Demographics
NPI:1619966579
Name:COOK, JOHN WILLIAM (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIAM
Last Name:COOK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4000 BEESTON HILL MEDICAL CTR STE 9
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-5254
Mailing Address - Country:US
Mailing Address - Phone:340-718-0030
Mailing Address - Fax:340-718-0033
Practice Address - Street 1:4000 BEESTON HILL MEDICAL CTR STE 9
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-5254
Practice Address - Country:US
Practice Address - Phone:340-718-0030
Practice Address - Fax:340-718-0033
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0103000800213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
T83213Medicare UPIN