Provider Demographics
NPI:1083811475
Name:COOK, SEAN TRISTAN LAWRENCE (DO)
Entity Type:Individual
Prefix:DR
First Name:SEAN TRISTAN
Middle Name:LAWRENCE
Last Name:COOK
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2003 KOOTENAI HEALTH WAY
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-6051
Mailing Address - Country:US
Mailing Address - Phone:208-625-5085
Mailing Address - Fax:208-625-5731
Practice Address - Street 1:2120 W IRONWOOD CENTER DR
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2639
Practice Address - Country:US
Practice Address - Phone:208-625-6944
Practice Address - Fax:208-625-6945
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDO1019207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease