| H. Russell Cook, D.O. | |
|
207 E Watts St Suite 220 Enterprise AL 36330-1801 | |
| (334) 393-1056 | |
| (334) 393-6187 |
| Full Name | H. Russell Cook, D.O. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 207 E Watts St, Enterprise, Alabama |
| Authorized Official Name and Position | H. Russell Cook (OWNER) |
| Authorized Official Contact | 3343931056 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| H. Russell Cook, D.O. Po Box 310210 Enterprise AL 36331-0210 Ph: (334) 393-1056 | H. Russell Cook, D.O. 207 E Watts St Suite 220 Enterprise AL 36330-1801 Ph: (334) 393-1056 |
| NPI Number | 1710322987 |
|---|---|
| Provider Enumeration Date | 05/01/2013 |
| Last Update Date | 12/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710322987 | NPI | - | NPPES |
| 000014819 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | DO126 (Alabama) | Primary |
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