Individual
SAM D COOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2402 HARRISON ST, BATESVILLE, AR 72501-7421
(870) 793-4681
Mailing address
2402 HARRISON ST, BATESVILLE, AR 72501-7421
(870) 793-4681
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2291
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102740722
—
AR
Enumeration date
12/04/2006
Last updated
06/24/2014
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