Organization
ALBERT CROOK, DO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT ALLEN CROOK D.O. (OWNER)
(208) 667-9400
Entity
Organization
Contact information
Practice address
1103 W. IRONWOOD DRIVE, SUITE A, COEUR D' ALENE, ID 83814-2604
(208) 667-9400
(208) 667-2119
Mailing address
1103 W. IRONWOOD DRIVE, SUITE A, COEUR D' ALENE, ID 83814-2604
(208) 667-9400
(208) 667-2119
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0-134
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010138014
REGENCE BLUESHIELD OF ID
ID
05
—
806409200
—
ID
01
—
S5452
BLUE CROSS OF IDAHO
ID
Enumeration date
07/21/2006
Last updated
03/18/2014
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