Provider Demographics
NPI:1124589908
Name:COOK, ALEX EMORY (DO)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:EMORY
Last Name:COOK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 WORNALL RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3241
Mailing Address - Country:US
Mailing Address - Phone:816-932-2107
Mailing Address - Fax:816-932-2843
Practice Address - Street 1:4401 WORNALL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3241
Practice Address - Country:US
Practice Address - Phone:816-932-2107
Practice Address - Fax:816-932-2843
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-26
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20220399492085R0202X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology