Most Relevant Information
Provider Data
| NPI Number: | 1003370230 |
| Provider Name: | KIMBERLY M COOK |
| Entity Type: | Individual |
| Taxonomy Code: | 171000000X |
| Specialty: | Military Health Care Provider |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/22/2019 |
| Last Updated: | 09/12/2024 |
Provider Practice Location
2500 N STATE ST
JACKSON
MS
392164500
Practice Location Phone/Fax
| Phone: | 6018151312 |
| Fax: |
Provider Mailing Location
1650 COCHRANE CIR UNIT MEDDAC
FORT CARSON
CO
809134604
Provider Mailing Phone/Fax
| Phone: | 7195267000 |
| Fax: |