Individual
DR. CHARLES MILTON COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3333 RIVERBEND DR, SPRINGFIELD, OR 97477-8800
(541) 222-3154
(541) 222-3359
Mailing address
PO BOX 7247, SPRINGFIELD, OR 97475-0011
(541) 686-9551
(541) 687-6716
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD14613
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050005893
RR MEDICARE
OR
05
—
1020130
—
WA
05
—
178970
—
OR
05
—
XPY194083
—
CA
Enumeration date
02/21/2006
Last updated
10/27/2020
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