Individual
JACKSON BRYANT COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
706 DIXIE ST STE 220, CARROLLTON, GA 30117-3889
(770) 812-8640
(770) 838-8650
Mailing address
5725 BRENDA DR SW, MABLETON, GA 30126-3121
(256) 278-8842
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN-NP316440
GA
Other
Enumeration date
07/24/2025
Last updated
10/10/2025
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