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General NPI Number Information
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NPI Number | 1932435880
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Entity Type | Organization
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Legal Business Name | DOUGLAS W COOK MD INC
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Dates
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Enumeration Date | 10/28/2009
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 205 S WEST ST SUITE C
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City | VISALIA
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State | CA
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Zip | 93291-6112
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Country | US
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Telephone | 559-627-0800
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Fax | 559-627-0888
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Provider Business Mailing Address
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Address Line | 205 S WEST ST SUITE C
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City | VISALIA
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State | CA
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Zip | 93291-6112
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Country | US
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Telephone | 559-627-0800
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Fax | 559-627-0888
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Authorized Official
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Title or Position | CEO
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Name | DOUGLAS W COOK
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Credential | M.D.
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Telephone | 559-584-2759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A98414
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License Number State | CA
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