Individual
DR. LANE MARSHALL COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4428 SUTHERLAND AVE, KNOXVILLE, TN 37919-5008
(865) 588-6425
(865) 584-8066
Mailing address
PO BOX 10187, KNOXVILLE, TN 37939-0187
(865) 588-6425
(865) 584-8066
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD014748
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25080
BLUE CROSS IDENTIFIER
TN
01
—
3713251
MEDICARE INDIVIDUAL PTAN
TN
05
—
3713251
—
TN
Enumeration date
12/17/2005
Last updated
02/27/2008
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