NPI 1588041719 · live from the CMS NPI Registry
Jordan C Cook, DO
Dermatology in Springfield, OR. National Provider Identifier 1588041719, active.
NPI record
| NPI | 1588041719 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 21 Hayden Bridge Way, Springfield, OR 97477 |
| Practice phone | 541-600-2017 |
| Enumerated | April 27, 2015 |
| Last updated | September 16, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | DO221863 (OR) |
| Student in an Organized Health Care Education/Training Program | 390200000X | — (OR) |
| Dermatology | 207N00000X | 87784 (MT) |
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.