1336620293 NPI number — MARGARET PREVETZ COOK NP

Table of content: MARGARET PREVETZ COOK NP (NPI 1336620293)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336620293 NPI number — MARGARET PREVETZ COOK NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COOK
Provider First Name:
MARGARET
Provider Middle Name:
PREVETZ
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COOK
Provider Other First Name:
MARGARET
Provider Other Middle Name:
PREVETZ
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1336620293
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14536 CLARK STATE RD SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PATASKALA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43062-9772
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-270-4040
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2231 N HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43201-1194
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-293-2700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  APRN.CNP.021608 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QA0505X , with the licence number: APRN.CNP.021608 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)