Provider Demographics
NPI:1114091972
Name:COOK, SCOTT F (DC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:F
Last Name:COOK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4112 AUSTIN BLUFFS PKWY
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-2928
Mailing Address - Country:US
Mailing Address - Phone:719-548-8611
Mailing Address - Fax:719-548-8612
Practice Address - Street 1:4112 AUSTIN BLUFFS PKWY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-2928
Practice Address - Country:US
Practice Address - Phone:719-548-8611
Practice Address - Fax:719-548-8612
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5503111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOB2396OtherBCBS PROVIDER NUMBER
COCO668324OtherBCBS GROUP NUMBER
COCO668324OtherBCBS GROUP NUMBER
COU97478Medicare UPIN
COC515208Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER