Healthcare Provider Details

I. General information

NPI: 1336233626
Provider Name (Legal Business Name): BILLY J COLE II D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 01/12/2025
Certification Date: 01/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 BILL BAKER WAY
BECKLEY WV
25801-1506
US

IV. Provider business mailing address

252 RURAL ACRES DR
BECKLEY WV
25801-3503
US

V. Phone/Fax

Practice location:
  • Phone: 304-461-1110
  • Fax: 304-461-1105
Mailing address:
  • Phone: 304-253-2628
  • Fax: 304-252-1720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1924
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: