Individual
ROGER A COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 HOSPITAL WAY, POCATELLO, ID 83201-5175
(208) 239-1000
Mailing address
PO BOX 4107, POCATELLO, ID 83205-4107
(208) 233-8880
(208) 232-1950
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
11302
MT
207L00000X
Anesthesiology Physician
Primary
M11396
ID
207L00000X
Anesthesiology Physician
MD-54947
IA
207L00000X
Anesthesiology Physician
MD229174
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003966227
—
ID
01
—
11302
MONTANA LICENSE NUMBER
MT
01
—
M11396
IDAHO MEDICAL LICENSE
ID
Enumeration date
01/11/2007
Last updated
05/13/2026
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