Provider Demographics
NPI:1790979268
Name:COOK, KATHERINE MCKINSTRY
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MCKINSTRY
Last Name:COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MCKINSTRY
Other - Last Name:VOGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2210 SAMUEL COLT CT
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84060-7423
Mailing Address - Country:US
Mailing Address - Phone:801-835-6153
Mailing Address - Fax:
Practice Address - Street 1:DIVISON OF EMERGENCY MEDICINE
Practice Address - Street 2:30 NORTH 1900 EAST 1C026
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0001
Practice Address - Country:US
Practice Address - Phone:801-581-2417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6353573-1205207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine