Provider Demographics
NPI:1336193697
Name:COOK, CHRISTOPHER O (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:O
Last Name:COOK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 E. MAIN STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5689
Mailing Address - Country:US
Mailing Address - Phone:970-240-3338
Mailing Address - Fax:970-240-1541
Practice Address - Street 1:1825 EAST MAIN STREET
Practice Address - Street 2:SUITE A
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401
Practice Address - Country:US
Practice Address - Phone:970-240-3338
Practice Address - Fax:970-240-1541
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO628213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00380493OtherRRB
CO18138225Medicaid
U90658Medicare UPIN
CO18138225Medicaid
COC806724Medicare PIN