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General NPI Number Information
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NPI Number | 1124032008
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Entity Type | Individual
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Provider Name | CHRISTOPHER BUNYAN COLE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 10/13/2011
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Provider Practice Location Address
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Address Line | 1005 W MARKET ST SUITE B
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City | ATHENS
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State | AL
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Zip | 35611-2454
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Country | US
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Telephone | 256-230-3061
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Fax | 256-230-3009
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Provider Business Mailing Address
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Address Line | 142 N SEQUOIA BLVD
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City | FLORENCE
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State | AL
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Zip | 35630-1058
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Country | US
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Telephone | 256-683-6400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-103545
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License Number State | IL
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