Individual
DR. JACK L ROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
923 W COLORADO AVE, COLORADO SPRINGS, CO 80905-1517
(719) 227-0101
(719) 227-0303
Mailing address
923 W COLORADO AVE, COLORADO SPRINGS, CO 80905-1517
(719) 227-0101
(719) 227-0303
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
30128
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01-301282
—
CO
01
—
C77721
MEDICARE P-TAN
CO
Enumeration date
12/04/2006
Last updated
03/05/2012
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