Individual
DR. STACY COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
WILFORD HALL AMBULATORY SURGICAL CENTER, 1100 WILFORD HALL LOOP, BLDG. 4554, 59 MDW/GME, JBSA LACKLAND, TX 78236-9908
(757) 362-2613
Mailing address
WILFORD HALL AMBULATORY SURGICAL CENTER, 1100 WILFORD HALL LOOP, BLDG. 4554, APO, AA 78236-9908
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
DR.0068502
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/01/2020
Last updated
04/12/2022
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