Provider Demographics
NPI:1902547383
Name:COOK INTERNAL MEDICINE
Entity Type:Organization
Organization Name:COOK INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C0-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRANESE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-820-0918
Mailing Address - Street 1:3588 HIGHWAY 138 SE APT 183
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-4171
Mailing Address - Country:US
Mailing Address - Phone:678-469-1471
Mailing Address - Fax:
Practice Address - Street 1:3200 HIGHLANDS PKWY
Practice Address - Street 2:SUITE #105
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082
Practice Address - Country:US
Practice Address - Phone:678-469-1471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty