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General NPI Number Information
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NPI Number | 1588638969
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Entity Type | Individual
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Provider Name | KELLY L COLE D.O.
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Gender | Female
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 11/20/2007
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Provider Practice Location Address
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Address Line | 121 E MAIN ST
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City | PROVIDENCE
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State | KY
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Zip | 42450-1268
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Country | US
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Telephone | 270-667-2023
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Fax | 270-667-7518
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Provider Business Mailing Address
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Address Line | PO BOX 310
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City | PROVIDENCE
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State | KY
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Zip | 42450-0310
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Country | US
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Telephone | 270-667-2023
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Fax | 270-667-7518
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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 | 02437
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License Number State | KY
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