Provider Demographics
NPI:1841887718
Name:COOK, TANNER (PA-C, MBA)
Entity type:Individual
Prefix:
First Name:TANNER
Middle Name:
Last Name:COOK
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Gender:
Credentials:PA-C, MBA
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1923 SOUTH UTICA AVENUE
Mailing Address - Street 2:SIEGFRIED TOWER, 4TH FLOOR
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-6520
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1923 SOUTH UTICA AVENUE
Practice Address - Street 2:SIEGFRIED TOWER, 4TH FLOOR
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-6520
Practice Address - Country:US
Practice Address - Phone:505-918-8388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2025-04-04
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty