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General NPI Number Information
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NPI Number | 1205940467
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Entity Type | Individual
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Provider Name | JUDE COOK M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 09/06/2019
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Provider Practice Location Address
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Address Line | 8338 W 13TH ST N
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City | WICHITA
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State | KS
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Zip | 67212
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Country | US
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Telephone | 316-729-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 8338 W 13TH ST N
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City | WICHITA
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State | KS
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Zip | 67212-2900
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 20027
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 04-38402
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License Number State | KS
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