Provider Demographics
NPI:1740234780
Name:COOK, WILLIAM T (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:T
Last Name:COOK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1267 HIGHWAY 54 W
Mailing Address - Street 2:SUITE 3200
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-4526
Mailing Address - Country:US
Mailing Address - Phone:770-632-9900
Mailing Address - Fax:770-632-9997
Practice Address - Street 1:1267 HIGHWAY 54 W
Practice Address - Street 2:SUITE 3200
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4526
Practice Address - Country:US
Practice Address - Phone:770-632-9900
Practice Address - Fax:770-632-9997
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA032461207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE99184Medicare UPIN
GA16BDBHVMedicare ID - Type Unspecified