Individual
DR. BARRY MOORE MCCOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, UFJP RADIOLOGY, JACKSONVILLE, FL 32209-6511
(904) 244-4221
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD054903L
PA
2085R0202X
Diagnostic Radiology Physician
Primary
ME0050576
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001741042
—
PA
01
—
08426
BCBS
FL
05
—
2814064-00
—
FL
Enumeration date
02/16/2006
Last updated
02/17/2009
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