Individual
JASON ANDREW HOOVER COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14712 VICTOR HUGO BLVD., SUITE 4, HUGO, MN 55038-9458
(651) 777-2362
(651) 332-8554
Mailing address
3555 WILLOW LAKE BLVD., SUITE 140, VADNAIS HEIGHTS, MN 55110-4462
(651) 770-2124
(651) 251-5282
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036119192
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2429394
—
OH
Enumeration date
01/24/2007
Last updated
02/21/2014
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