Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 16678 | AL |
NPI | 1285605055 |
---|---|
Provider Name | Barton B Cook |
First Address | Montgomery, AL 36117-3547 |
Second Address | Montgomery, AL 36117-3547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 11/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H12149 | (02) | AL |