Doctor Name: | MR. PHILLIP CRAIG COOKE |
NPI Number: | 1104905504 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSPT |
License Number: | 000986 |
Business Practice Address: | 1199 Pineview Dr Morgantown, WV - 265052700 |
Business Phone Number: | 3045982212 |
Business Fax Number: | 3045982258 |
Mailing Address: | 1199 Pineview Dr, MORGANTOWN |
State: | WV |
Postal Code: | 265052700 |
Phone Number: | 3045982212 |
Fax Number: | 3045982258 |
NPI Enumeration Date: | 11/04/2006 |
NPI Last Update Date: | 03/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261Q00000X |
License Number: | 000986 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |