Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 641 | TN |
NPI | 1073500823 |
---|---|
Provider Name | Dr. Laurel B Cook I |
First Address | Knoxville, TN 37923-2441 |
Second Address | Maryville, TN 37803-6100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 08/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4127412 | (05) | TN |
U71317 | (02) | TN |