Cooke, Sam D
Cooke, Sam D is an sole proprietor health care provider with primary practice located at 2402 Harrison St , Batesville AR 72501-7421. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Cooke, Sam D can be contacted via phone (870) 793-4681.Contact Information
Primary practice address
2402 Harrison St
Batesville AR 72501-7421
Phone: (870) 793-4681
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2291 | Arkansas |
Profile Details
| NPI number | 1780752022 |
|---|---|
| LBN Legal business name | Cooke, Sam D |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 4th, 2006 |
| Last updated | Jun 24th, 2014 - about 10 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 | 1780752022 | NPPES |
| Arkansas | MEDICAID | 102740722 |
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