Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 5364 | OK |
NPI | 1003256397 |
---|---|
Provider Name | Dr. Hunter Dale Cook |
First Address | Oklahoma City, OK 73109-3413 |
Second Address | Oklahoma City, OK 73109-3413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2013 |
Last Update Date | 01/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5364 | OKLAHOMA STATE BOARD OF OSTEOPATHIC EXAMINERS (01) | OK |