Provider Demographics
NPI:1285873505
Name:COOK, JOHN V (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:V
Last Name:COOK
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1210 KY HIGHWAY 36 E
Mailing Address - Street 2:SUITE G3
Mailing Address - City:CYNTHIANA
Mailing Address - State:KY
Mailing Address - Zip Code:41031-7490
Mailing Address - Country:US
Mailing Address - Phone:859-234-9222
Mailing Address - Fax:859-234-5666
Practice Address - Street 1:1210 KY HIGHWAY 36 E
Practice Address - Street 2:SUITE G3
Practice Address - City:CYNTHIANA
Practice Address - State:KY
Practice Address - Zip Code:41031-7490
Practice Address - Country:US
Practice Address - Phone:859-234-9222
Practice Address - Fax:859-234-5666
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2013-10-17
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Provider Licenses
StateLicense IDTaxonomies
KYPA296363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant