Individual
GLENDON E COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 NW HAWTHORNE AVE, GRANTS PASS, OR 97526-1051
(541) 472-4777
(541) 471-1439
Mailing address
1701 NW HAWTHORNE AVE, GRANTS PASS, OR 97526-1051
(541) 472-4777
(541) 471-1439
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD223655
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000266485
UNISON
PA
01
—
000063294
BLUESHIELD
PA
05
—
101764792-0001
—
PA
05
—
500850811
—
OR
01
—
824355
FPH
PA
Enumeration date
06/12/2006
Last updated
04/07/2025
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