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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063857753 NPPES
Indiana MEDICAID 300014045

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