Provider Demographics
NPI:1508124264
Name:COOK, EMILY (DO)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 E 1200 N
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-2633
Mailing Address - Country:US
Mailing Address - Phone:480-570-2580
Mailing Address - Fax:
Practice Address - Street 1:620 E 1200 N
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-2633
Practice Address - Country:US
Practice Address - Phone:480-570-2580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9540057-1204207Q00000X
UT9450057-1724207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine