Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | TAO589 | MD |
NPI | 1013070432 |
---|---|
Provider Name | Dr. Alan Douglas Cook |
First Address | Frostburg, MD 21532-1336 |
Second Address | Frostburg, MD 21532-1336 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 08/07/2007 |