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NPI Code Detail

MEDICARE: DR. LORAN DAVIS COOK M.D.

MEDICARE: DR. LORAN DAVIS COOK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist1550231205UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396741948
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LORAN DAVIS COOK M.D.
Provider Business Mailing Address
First Line : 1055 N 300 W
Second Line :
City : PROVO
State : UT
Zip : 84604-3344
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1055 N 300 W
Second Line : STE 204
City : PROVO
State : UT
Zip : 84604-3374
Country : US
Telephone Number : 801-357-7373
Fax Number : 801-357-7217
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 06/03/2008

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Directions to “ DR. LORAN DAVIS COOK M.D.” Practice Location

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