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Individual

MARK R COOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1914 LELARAY ST, COLORADO SPRINGS, CO 80909-2800
(719) 632-7641
(719) 632-7641
Mailing address
1914 LELARAY ST, COLORADO SPRINGS, CO 80909-2800
(719) 632-7641
(719) 632-2925

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
47859
CO
207RN0300X
Nephrology Physician
Primary
47859
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000149831
CO
Enumeration date
04/04/2007
Last updated
05/11/2022
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