Healthcare Provider Details

I. General information

NPI: 1871770735
Provider Name (Legal Business Name): ROBERT T COLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ROB COLE MD

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 02/11/2021
Certification Date: 02/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 COLLIER RD NW STE 3000
ATLANTA GA
30309-1721
US

IV. Provider business mailing address

PO BOX 116116
ATLANTA GA
30368-6116
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-5422
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number060164
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number0101266226
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number060164
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: