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General NPI Number Information
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NPI Number | 1487148243
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Entity Type | Individual
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Provider Name | COLE MCKEE RICHARDSON DO
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Gender | Male
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Dates
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Enumeration Date | 06/15/2018
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 109 MILLSAPS DR
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City | HATTIESBURG
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State | MS
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Zip | 39402-1587
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Country | US
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Telephone | 601-818-2957
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Fax |
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Provider Business Mailing Address
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Address Line | 109 MILLSAPS DR STE B
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City | HATTIESBURG
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State | MS
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Zip | 39402-1587
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Country | US
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Telephone | 601-255-0736
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 5151009600
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 33128
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 33128
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License Number State | MS
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