Provider Demographics
NPI:1669476685
Name:COOK, CHERYL LYNN (MD)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:LYNN
Last Name:COOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:900 SAINT CHRISTOPHER DRIVE
Mailing Address - Street 2:BUILDING 4, SUITE 101
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-7032
Mailing Address - Country:US
Mailing Address - Phone:606-836-0919
Mailing Address - Fax:606-836-2847
Practice Address - Street 1:900 SAINT CHRISTOPHER DRIVE
Practice Address - Street 2:BUILDING 4, SUITE 101
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-7032
Practice Address - Country:US
Practice Address - Phone:606-836-0919
Practice Address - Fax:606-836-2847
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25781208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000550498OtherANTHEM BCBS
KY000000049253OtherANTHEM BCBS
OH0665310Medicaid
KY64257819Medicaid
KY000000049253OtherANTHEM BCBS