Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 01068128A | IN |
N | 111NI0900X | Internist | 01068128A | IN |
Y | 207RH0002X | Hospice and Palliative Medicine | 35091139 | OH |
NPI | 1043426844 |
---|---|
Provider Name | Robert E. Crook |
First Address | Independence, OH 44131-5032 |
Second Address | Independence, OH 44131-5032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 21/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2902961 | (05) | OH |
P00733036 | RAILROAD CARE (01) | OH |