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General NPI Number Information
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NPI Number | 1235231192
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Entity Type | Individual
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Provider Name | JOHN D. COOK DO
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Gender | Male
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 10/06/2009
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Provider Practice Location Address
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Address Line | 701 MADISON AVE
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City | MADISON
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State | WV
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Zip | 25130-1669
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Country | US
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Telephone | 304-369-1230
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Fax | 304-369-1255
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Provider Business Mailing Address
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Address Line | 701 MADISON AVE
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City | MADISON
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State | WV
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Zip | 25130-1669
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Country | US
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Telephone | 304-369-1230
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Fax | 304-369-1255
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1570
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 1570
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License Number State | WV
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