Healthcare Provider Details

I. General information

NPI: 1104483239
Provider Name (Legal Business Name): CHARLES LOUIS COLE III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 S 9TH ST STE 5
LEHIGHTON PA
18235-2517
US

IV. Provider business mailing address

801 OSTRUM ST
BETHLEHEM PA
18015-1000
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-6643
  • Fax:
Mailing address:
  • Phone: 484-526-6643
  • Fax: 484-526-4658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD488799
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: