Healthcare Provider Details

I. General information

NPI: 1538272133
Provider Name (Legal Business Name): DAVID E COOK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10462 S REDWOOD RD
SOUTH JORDAN UT
84095-8501
US

IV. Provider business mailing address

2776 W 10755 S
SOUTH JORDAN UT
84095-8645
US

V. Phone/Fax

Practice location:
  • Phone: 801-606-4307
  • Fax: 801-606-4315
Mailing address:
  • Phone: 217-791-3670
  • Fax: 801-606-4315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number10977432-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10977432-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: