Provider Demographics
NPI:1932134897
Name:COOK, ALBERT JAMES II (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:JAMES
Last Name:COOK
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 E MAIN ST
Mailing Address - Street 2:BOX 328
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-5818
Mailing Address - Country:US
Mailing Address - Phone:330-593-1030
Mailing Address - Fax:330-572-3836
Practice Address - Street 1:1044 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44504-1006
Practice Address - Country:US
Practice Address - Phone:330-480-2502
Practice Address - Fax:330-480-8609
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0654132085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0155844Medicaid
PA001625126OtherHIGHMARK
PA100934225Medicaid
OHP00177661Medicare PIN
OH4023038Medicare PIN
OH4092625Medicare PIN
OH300129247Medicare PIN
OH4092624Medicare PIN
PA100934225Medicaid
OHF23318Medicare UPIN
PAP00170381Medicare PIN
PA079439WDGMedicare PIN
PA079439SSJMedicare PIN
OH4092622Medicare PIN
PAP00170381Medicare PIN
OH4092625Medicare PIN
PA079439SSJMedicare PIN