Individual
GLEN E COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
725 N SANDUSKY AVE STE 3, BUCYRUS, OH 44820-1463
(419) 562-4966
(419) 562-5119
Mailing address
5400 FRANTZ RD STE 250, DUBLIN, OH 43016-6102
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35-065244
OH
207RC0000X
Cardiovascular Disease Physician
35065244
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0945893
—
OH
Enumeration date
06/04/2006
Last updated
01/25/2022
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