Individual
DR. JONATHAN F COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
6 TURNPIKE ACRES ROAD, GRAY, ME 04039
(207) 657-4488
(207) 657-4574
Mailing address
PO BOX 1088, GRAY, ME 04039-1088
(207) 657-4488
(207) 657-4574
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT855
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100225
ANTHEM
ME
01
—
134208862
GROUP TAX ID#
ME
01
—
1821106105
GROUP NPI
ME
05
—
291370099
—
ME
01
—
MM9663
MEDICARE GROUP #
ME
Enumeration date
10/17/2005
Last updated
05/26/2009
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