Healthcare Provider Details

I. General information

NPI: 1003252453
Provider Name (Legal Business Name): COLE MCEWEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2013
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 8TH ST
BELOIT KS
67420-1605
US

IV. Provider business mailing address

400 W 8TH ST
BELOIT KS
67420-1605
US

V. Phone/Fax

Practice location:
  • Phone: 785-738-2266
  • Fax:
Mailing address:
  • Phone: 857-382-2667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number04-46162
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number55831
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: