Individual
DR. JOHN R COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
11685
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E929440282
MCR/MCCORMICK OFFICE
SC
05
—
GP2477
—
SC
Enumeration date
06/08/2005
Last updated
08/29/2019
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