MEDICARE: MICHAEL S 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
1	207Q00000X	Family Medicine Physician	C5870	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710973649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL S COLE MD

Provider Business Mailing Address
First Line	:	PO BOX 11449
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4005
Country	:	US
Telephone Number	:	479-709-1924
Fax Number	:	479-709-7499

Provider Business Practice Location Address
First Line	:	6100 MASSARD RD
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72916-8886
Country	:	US
Telephone Number	:	479-709-7250
Fax Number	:	479-709-7251

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	11/23/2016

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