Individual
DR. MICHAEL G COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3044 GOODMAN ROAD EAST, SOUTHAVEN, MS 38672-8760
(662) 349-1660
(662) 349-1663
Mailing address
3044 GOODMAN ROAD EAST, SOUTHAVEN, MS 38672-8760
(662) 349-1660
(662) 349-1663
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
467
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00880118
—
MS
Enumeration date
08/05/2006
Last updated
10/30/2008
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