Individual
JOHN HENRY COOK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
224D CORNWALL ST NW, SUITE 102, LEESBURG, VA 20176-2700
(703) 777-1146
(703) 777-3144
Mailing address
PO BOX 17334, BALTIMORE, MD 21297-1334
(703) 443-6717
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101030448
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05841771
—
VA
01
—
110204720
RR MEDICARE
—
Enumeration date
09/07/2005
Last updated
01/09/2010
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