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NPI Code Detail

MEDICARE: DR. JO A COOKE-BARBER M.D.

MEDICARE: DR. JO A COOKE-BARBER 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
1208600000XSurgery Physician74214GA
22086S0120XPediatric Surgery Physician01094198AIN

General Provider Information

NPI Number : 1417215922
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JO A COOKE-BARBER M.D.
Provider Business Mailing Address
First Line : 7613 W JEFFERSON BLVD STE 200
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4182
Country : US
Telephone Number : 260-469-7337
Fax Number : 260-469-7340
Provider Business Practice Location Address
First Line : 7613 W JEFFERSON BLVD STE 200
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-4182
Country : US
Telephone Number : 260-469-7337
Fax Number : 260-469-7340
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2012
Last Update Date : 07/02/2024

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