MEDICARE: DR. JULIE A COLE O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	0802	NH
2	152W00000X	Optometrist	4731	MA
3	152W00000X	Optometrist	2106	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962698365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE A COLE O.D.

Provider Business Mailing Address
First Line	:	312 E CENTERVIEW ST
Second Line	:
City	:	CHINA GROVE
State	:	NC
Zip	:	28023-2553
Country	:	US
Telephone Number	:	704-857-5464
Fax Number	:	704-857-6732

Provider Business Practice Location Address
First Line	:	312 E CENTERVIEW ST
Second Line	:
City	:	CHINA GROVE
State	:	NC
Zip	:	28023-2553
Country	:	US
Telephone Number	:	704-857-5464
Fax Number	:	704-857-6732

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2007
Last Update Date	:	02/14/2012

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