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General NPI Number Information
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NPI Number | 1184933558
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Entity Type | Organization
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Legal Business Name | KENNETH G COOK MD PSC
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Dates
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Enumeration Date | 10/01/2010
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Last Update Date | 10/01/2010
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Provider Practice Location Address
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Address Line | 225 MEDICAL CENTER DR SUITE 208C
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City | PADUCAH
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State | KY
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Zip | 42003-7914
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Country | US
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Telephone | 270-441-4144
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Fax | 270-441-4646
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Provider Business Mailing Address
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Address Line | 225 MEDICAL CENTER DR SUITE 208C
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City | PADUCAH
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State | KY
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Zip | 42003-7914
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Country | US
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Telephone | 270-441-4144
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Fax | 270-441-4646
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. KENNETH GENE COOK
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Credential | MD
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Telephone | 270-441-4144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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