Provider Demographics
NPI:1952799264
Name:JAMES R. COOK, MD
Entity type:Organization
Organization Name:JAMES R. COOK, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:417-883-3963
Mailing Address - Street 1:2333 E GLENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-3320
Mailing Address - Country:US
Mailing Address - Phone:417-883-3963
Mailing Address - Fax:
Practice Address - Street 1:2333 E GLENWOOD ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-3320
Practice Address - Country:US
Practice Address - Phone:417-883-3963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO29093261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain