Cook, Brandon Wade
Cook, Brandon Wade is an individual health care provider with primary practice located at 1034 Mar Walt Dr Unit 100 , Fort Walton Beach FL 32547. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Cook, Brandon Wade can be contacted via phone (850) 860-2153.Contact Information
Primary practice address
1034 Mar Walt Dr Unit 100
Fort Walton Beach FL 32547
Phone: (850) 860-2153
Fax: (850) 315-9350
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 51035 | Kentucky |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | 51035 | Kentucky |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | ME139218 | Florida |
Profile Details
| NPI number | 1063857753 |
|---|---|
| LBN Legal business name | Cook, Brandon Wade |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 8th, 2013 |
| Last updated | Aug 2nd, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063857753 | NPPES |
| Indiana | MEDICAID | 300014045 |
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