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General NPI Number Information
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NPI Number | 1407142441
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Entity Type | Individual
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Provider Name | ROBERT DAVID COLE JR. O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2011
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Last Update Date | 11/16/2016
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Provider Practice Location Address
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Address Line | 488 W HOSPITAL RD SUITE 1
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City | PAOLI
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State | IN
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Zip | 47454-8807
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Country | US
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Telephone | 812-723-4752
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Fax | 812-723-4753
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Provider Business Mailing Address
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Address Line | 488 W HOSPITAL RD STE 1
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City | PAOLI
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State | IN
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Zip | 47454-8808
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Country | US
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Telephone | 812-620-4339
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18003673A
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License Number State | IN
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