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General NPI Number Information
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NPI Number | 1245266634
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Entity Type | Organization
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Legal Business Name | CENTER FOR SLEEP & WAKE DISORDERS
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 MEADOW DR
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City | DANVILLE
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State | IN
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Zip | 46122-1414
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Country | US
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Telephone | 317-745-3980
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Fax | 317-745-3988
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Provider Business Mailing Address
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Address Line | 100 MEADOW DR
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City | DANVILLE
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State | IN
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Zip | 46122-1414
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Country | US
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Telephone | 317-745-3980
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Fax | 317-745-3988
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Authorized Official
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Title or Position | CEO
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Name | DR. JAMES S COOK
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Credential | MD
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Telephone | 317-745-3980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 01029809A
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License Number State | IN
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