Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 34262 | CO |
NPI | 1558437681 |
---|---|
Provider Name | Dr. W Donald Cooke |
First Address | Durango, CO 81301-5046 |
Second Address | Durango, CO 81301-5046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 29/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01342625 | (05) | CO |
D35578 | (02) |