Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 0101044466 | VA |
NPI | 1336121052 |
---|---|
Provider Name | William A Cook III |
First Address | Madison Heights, VA 24572-2536 |
Second Address | Lynchburg, VA 24501-2148 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2005 |
Last Update Date | 30/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D09358 | (02) | VA |