Provider Demographics
NPI:1477176543
Name:COOK, MARTIN EARL (DO)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:EARL
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:PO BOX 689022
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-9022
Mailing Address - Country:US
Mailing Address - Phone:615-465-7211
Mailing Address - Fax:
Practice Address - Street 1:2480 S WOODWORTH LOOP STE 150
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-7408
Practice Address - Country:US
Practice Address - Phone:907-861-6312
Practice Address - Fax:907-861-6322
Is Sole Proprietor?:No
Enumeration Date:2020-05-24
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK212767207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine