Provider Demographics
NPI:1992086516
Name:COOKE, AARON KYLE (OD)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:KYLE
Last Name:COOKE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9529 W STATE ROAD 56
Mailing Address - Street 2:
Mailing Address - City:FRENCH LICK
Mailing Address - State:IN
Mailing Address - Zip Code:47432-9708
Mailing Address - Country:US
Mailing Address - Phone:812-936-5222
Mailing Address - Fax:812-936-5225
Practice Address - Street 1:9529 W STATE ROAD 56
Practice Address - Street 2:
Practice Address - City:FRENCH LICK
Practice Address - State:IN
Practice Address - Zip Code:47432-9708
Practice Address - Country:US
Practice Address - Phone:812-936-5222
Practice Address - Fax:812-936-5225
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003699A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist