Individual
MR. RICHARD MYLES COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1630 HOSPITAL DR, SUITE A, SANTA FE, NM 87505-4772
(505) 424-0200
(505) 424-6608
Mailing address
1630 HOSPITAL DR, SUITE A, SANTA FE, NM 87505-4772
(505) 424-0200
(505) 424-6608
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
96PA-21
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L9125
—
NM
Enumeration date
07/20/2006
Last updated
04/08/2013
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