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General NPI Number Information
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NPI Number | 1578558441
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Entity Type | Individual
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Provider Name | RICHARD CLINTON COLE MD
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Gender | Male
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 2106 N JACKSON ST
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City | TULLAHOMA
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State | TN
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Zip | 37388-2208
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Country | US
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Telephone | 931-455-2045
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Fax | 931-455-9960
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Provider Business Mailing Address
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Address Line | 2106 N JACKSON ST
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City | TULLAHOMA
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State | TN
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Zip | 37388-2208
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Country | US
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Telephone | 931-455-2045
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Fax | 931-455-9960
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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 | MD021619
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License Number State | TN
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