Carlton P Cooke III, M.D.
Individual provider Active NPI Orthopaedic Surgery Physician · De Witt, NY
NPI 1194780494 · NPPES record last updated Dec 1, 2015
Key facts
- NPI
- 1194780494
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- 131641 (NY)
- Practice address
- 5719 Widewaters Pkwy
De Witt, NY 13214-1880 - Phone
- (315) 251-3100
- Fax
- (315) 449-9923
- NPI assigned
- Apr 19, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 131641 | NY | MD | Orthopaedic Surgery Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 131641 | NY | Yes |
Addresses
Primary practice location
5719 Widewaters Pkwy
De Witt, NY 13214-1880
Mailing address
5719 Widewaters Pkwy
Syracuse, NY 13214-1880
Phone (315) 251-3100
Other providers in De Witt, NY
- Noah Brown
- John J Cambareri
- Childress Chiropractic PC
- Cody Childress
- Cole Vision Corporation
- Katie Curran IV
- Susan E Davoli
- Wendy Decker
- Elizabeth Defreitas
- Scott Codwise Dickinson
All providers in De Witt, NY · Orthopaedic Surgery Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.