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NPI Code Detail

MEDICARE: DR. JUSTIN GARRETT COLE MD

MEDICARE: DR. JUSTIN GARRETT COLE MD
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
1207Q00000XFamily Medicine PhysicianLL84326SC
2207Q00000XFamily Medicine Physician70114AZ

General Provider Information

NPI Number : 1366068413
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUSTIN GARRETT COLE MD
Provider Business Mailing Address
First Line : 1811 E MCMURRAY BLVD
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85122-5404
Country : US
Telephone Number : 520-374-6530
Fax Number :
Provider Business Practice Location Address
First Line : 1811 E MCMURRAY BLVD
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85122-5404
Country : US
Telephone Number : 520-374-6530
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2020
Last Update Date : 08/02/2023

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Directions to “ DR. JUSTIN GARRETT COLE MD” Practice Location

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