Individual
MARSHALL LEWIS COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504-0649
(928) 729-8000
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(928) 729-8000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
19360
AZ
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
AZ19360
AZ
Other
Enumeration date
12/29/2005
Last updated
03/17/2022
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