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General NPI Number Information
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NPI Number | 1508124264
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Entity Type | Individual
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Provider Name | EMILY COOK DO
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Gender | Female
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Dates
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Enumeration Date | 05/01/2012
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 25 S MAIN ST STE 202
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City | CENTERVILLE
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State | UT
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Zip | 84014-1840
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Country | US
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Telephone | 801-663-6656
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Fax | 801-810-1696
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Provider Business Mailing Address
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Address Line | 1538 27TH ST
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City | OGDEN
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State | UT
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Zip | 84403-0411
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Country | US
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Telephone | 480-570-2580
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Fax | 480-879-2526
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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 | 9540057-1204
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License Number State | UT
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