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Individual

DAVID COOKSEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1455 E BERT KOUNS LOOP, SHREVEPORT, LA 71105-5634
(318) 798-4677
(318) 798-4417
Mailing address
1455 E BERT KOUNS LOOP, SHREVEPORT, LA 71105-5634
(318) 798-4677
(318) 798-4417

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
012189
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070004786
RAILROAD MEDICARE NUMBER
LA
01
1053315846
GROUP NPI NUMBER
LA
05
1191884
LA
Enumeration date
06/08/2005
Last updated
01/12/2009
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