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NPI Code Detail

MEDICARE: JOHN ANDREW COLE M.D.

MEDICARE: JOHN ANDREW COLE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician065951GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1202I077955OTHERGAMEDICARE PTAN

General Provider Information

NPI Number : 1164684304
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN ANDREW COLE M.D.
Provider Business Mailing Address
First Line : 2410N OAK ST
Second Line :
City : VALDOSTA
State : GA
Zip : 31602-2533
Country : US
Telephone Number : 229-241-7546
Fax Number : 229-469-5722
Provider Business Practice Location Address
First Line : 2410N OAK ST
Second Line :
City : VALDOSTA
State : GA
Zip : 31602-2533
Country : US
Telephone Number : 229-241-7546
Fax Number : 229-469-5722
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2008
Last Update Date : 07/10/2015

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Directions to “ JOHN ANDREW COLE M.D.” Practice Location

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