Individual
AUDRA K COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
201 N MONTE VISTA ST, SUITE C, ADA, OK 74820-7213
(580) 453-3156
(580) 453-3157
Mailing address
201 N MONTE VISTA ST, SUITE C, ADA, OK 74820-7213
(580) 453-3156
(580) 453-3157
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22996
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200004740
—
OK
Enumeration date
06/23/2006
Last updated
08/05/2014
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