Provider Demographics
NPI:1265469019
Name:COOK, HAROLD E III (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:E
Last Name:COOK
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 RAVINE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-9322
Mailing Address - Country:US
Mailing Address - Phone:330-466-5189
Mailing Address - Fax:
Practice Address - Street 1:165 RAVINE RIDGE DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-9322
Practice Address - Country:US
Practice Address - Phone:330-466-5189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35067627207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0123360Medicaid
OH0773299Medicare ID - Type Unspecified
OH0123360Medicaid