Provider Demographics
NPI:1891729430
Name:COOK, ALBERT A (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:A
Last Name:COOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9810A MEDLOCK BRIDGE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-4405
Mailing Address - Country:US
Mailing Address - Phone:678-474-0151
Mailing Address - Fax:678-474-0152
Practice Address - Street 1:9810A MEDLOCK BRIDGE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-4405
Practice Address - Country:US
Practice Address - Phone:678-474-0151
Practice Address - Fax:678-474-0152
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0369462084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00612334KMedicaid
GA00612334KMedicaid
GA13BDDLKMedicare ID - Type UnspecifiedMEDICARE NUMBER