Individual
ALBERT ALLEN CROOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1103 W. IRONWOOD DRIVE, SUITE A, COEUR D'ALENE, ID 83814-2604
(208) 667-9400
(208) 667-9400
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
0134
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010138014
REGENCE BLUE SHIELD OF ID
ID
05
—
806409200
—
ID
01
—
S5452
BLUE CROSS OF ID
ID
Enumeration date
10/11/2005
Last updated
03/18/2014
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