Provider Demographics
NPI:1285897827
Name:COOK, CRYSTAL LYNN (MD)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LYNN
Last Name:COOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:704 W BUCHANAN ST
Practice Address - Street 2:
Practice Address - City:CALIFORNIA
Practice Address - State:MO
Practice Address - Zip Code:65018-1228
Practice Address - Country:US
Practice Address - Phone:573-796-3111
Practice Address - Fax:573-796-3042
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2025-01-09
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Provider Licenses
StateLicense IDTaxonomies
MO2011003927207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine