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General NPI Number Information
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NPI Number | 1952799264
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Entity Type | Organization
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Legal Business Name | JAMES R. COOK, MD
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Dates
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Enumeration Date | 01/08/2015
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Last Update Date | 01/08/2015
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Provider Practice Location Address
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Address Line | 2333 E GLENWOOD ST
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City | SPRINGFIELD
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State | MO
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Zip | 65804-3320
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Country | US
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Telephone | 417-883-3963
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Fax |
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Provider Business Mailing Address
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Address Line | 2333 E GLENWOOD ST
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City | SPRINGFIELD
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State | MO
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Zip | 65804-3320
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Country | US
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Telephone | 417-883-3963
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Fax |
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Authorized Official
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Title or Position | PRACTIONER
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Name | JAMES ROBERT COOK
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Credential | MD
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Telephone | 417-883-3963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 29093
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License Number State | MO
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