Healthcare Provider Details

I. General information

NPI: 1124589908
Provider Name (Legal Business Name): ALEX EMORY COOK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 WORNALL RD
KANSAS CITY MO
64111-3241
US

IV. Provider business mailing address

9629 HARVEST MOON LN APT 300
VERONA WI
53593-9672
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-2107
  • Fax: 816-932-2843
Mailing address:
  • Phone: 314-363-1779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2022039949
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number81399-21
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: