Individual
TIMOTHY A COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1325 SPRING ST, ANESTHESIA DEPT, GREENWOOD, SC 29646-3860
(864) 227-4111
Mailing address
PO BOX 819, GREENWOOD, SC 29648-0819
(864) 227-8242
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R87090
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN1057
—
SC
Enumeration date
01/20/2006
Last updated
10/04/2007
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