Healthcare Provider Details

I. General information

NPI: 1578968483
Provider Name (Legal Business Name): HYPERBARIC MEDICINE GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2014
Last Update Date: 11/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2-4 SUGAR ESTATE 5TH STREET
ST. THOMAS VI
00801-0000
US

IV. Provider business mailing address

P O BOX 10012 2-4 SUGAR ESTATE 5TH STREET
ST. THOMAS VI
00801-0000
US

V. Phone/Fax

Practice location:
  • Phone: 340-713-8400
  • Fax: 340-719-5103
Mailing address:
  • Phone: 340-713-8400
  • Fax: 340-719-5103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1058
License Number StateVI

VIII. Authorized Official

Name: DR. IAN K. COOK
Title or Position: PRESIDENT
Credential:
Phone: 36407138400