Cook, Keith R

Cook, Keith R is an individual health care provider with primary practice located at 301 Med Tech Pkwy Ste 240, Johnson City TN 37604-2364. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Cook, Keith R can be contacted via phone (423) 794-5520.

Contact Information

Primary practice address
301 Med Tech Pkwy Ste 240 Johnson City TN 37604-2364
Fax: (423) 282-6940
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 28176 Tennessee

Profile Details

NPI number 1396740957
LBN Legal business name Cook, Keith R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Mar 8th, 2021 - about 4 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 1396740957 NPPES
Tennessee MEDICAID 3811766

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