Provider Demographics
NPI:1861418014
Name:WILLIAM W COOK MD P C
Entity type:Organization
Organization Name:WILLIAM W COOK MD P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:COOK
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:405-947-3345
Mailing Address - Street 1:3366 NW EXPRESSWAY
Mailing Address - Street 2:SUITE 660
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4462
Mailing Address - Country:US
Mailing Address - Phone:405-947-3345
Mailing Address - Fax:405-946-6677
Practice Address - Street 1:3366 NW EXPRESSWAY ST
Practice Address - Street 2:SUITE 660
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4462
Practice Address - Country:US
Practice Address - Phone:405-947-3345
Practice Address - Fax:405-946-6677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9932174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK290011121OtherRAILROAD MEDICARE
OK100099640CMedicaid
OK300522247Medicare PIN
OKD34534Medicare UPIN