Provider Demographics
NPI:1306305594
Name:COOK, RYAN BYRNE (DO)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:BYRNE
Last Name:COOK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6234 W BEHREND DR APT 2114
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6915
Mailing Address - Country:US
Mailing Address - Phone:801-709-3588
Mailing Address - Fax:
Practice Address - Street 1:6234 W BEHREND DR APT 2114
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-6915
Practice Address - Country:US
Practice Address - Phone:801-709-3588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5160207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology