Provider Demographics
NPI:1417215922
Name:COOKE-BARBER, JO A (MD)
Entity type:Individual
Prefix:DR
First Name:JO
Middle Name:A
Last Name:COOKE-BARBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7613 W JEFFERSON BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-4182
Mailing Address - Country:US
Mailing Address - Phone:260-469-7337
Mailing Address - Fax:260-469-7340
Practice Address - Street 1:7613 W JEFFERSON BLVD STE 200
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-4182
Practice Address - Country:US
Practice Address - Phone:260-469-7337
Practice Address - Fax:260-469-7340
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA74214208600000X
IN01094198A2086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery