1861418014 NPI number — WILLIAM W COOK MD P C

Table of content: DR. HERBERT ARTHUR HOLMAN MD (NPI 1265404719)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861418014 NPI number — WILLIAM W COOK MD P C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM W COOK MD P C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861418014
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3366 NW EXPRESSWAY
Provider Second Line Business Mailing Address:
SUITE 660
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73112-4462
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-947-3345
Provider Business Mailing Address Fax Number:
405-946-6677

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3366 NW EXPRESSWAY ST
Provider Second Line Business Practice Location Address:
SUITE 660
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73112-4462
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-947-3345
Provider Business Practice Location Address Fax Number:
405-946-6677
Provider Enumeration Date:
07/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COOK
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
WESLEY
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
405-947-3345

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  9932 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 290011121 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".
  • Identifier: 100099640C , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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