Provider Demographics
NPI:1881705861
Name:COOK, WILLIAM P (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:COOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3340 NORTH CENTER ST #800
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-7406
Mailing Address - Country:US
Mailing Address - Phone:801-990-1911
Mailing Address - Fax:801-990-1912
Practice Address - Street 1:4401 HARRISON BOULEVARD
Practice Address - Street 2:MCKAY DEE HOSPITAL
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403
Practice Address - Country:US
Practice Address - Phone:801-387-2800
Practice Address - Fax:801-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT89-180636-1205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100501222Medicaid
UT107005221101OtherIHC
UT1502954OtherUMWA
UT37778OtherPEHP
AZ820739Medicaid
UT870545614CO1OtherEDUCATORS MUTUAL
UTQM0000075886OtherALTIUS
ID804069500Medicaid
WY104801500Medicaid
UT2090168OtherUNITED HEALTHCARE
UT53230OtherHEALTHY U
UTPRA07313OtherMOLINA
UT19945OtherDESERET MUTUAL
UT8597445OtherWORKERS COMP
UT37778OtherPEHP
UT050041048Medicare ID - Type UnspecifiedRAILROAD MEDICARE
UT1502954OtherUMWA