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General NPI Number Information
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NPI Number | 1487684999
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Entity Type | Individual
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Provider Name | COLEENE GWENETH COOKE MD
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Gender | Female
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 838 MARKET ST
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City | ZANESVILLE
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State | OH
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Zip | 43701-3718
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Country | US
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Telephone | 740-452-9319
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Fax | 740-452-2427
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Provider Business Mailing Address
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Address Line | 838 MARKET ST
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City | ZANESVILLE
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State | OH
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Zip | 43701-3718
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Country | US
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Telephone | 740-452-9319
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Fax | 740-452-2427
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 37000
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 48169-020
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License Number State | WI
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