MEDICARE: JESSE A 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	2085N0700X	Neuroradiology Physician	MT8011	MT
2	2085R0204X	Vascular & Interventional Radiology Physician	MT8011	MT
3	2085R0202X	Diagnostic Radiology Physician	8011	MT

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

General Provider Information

NPI Number	:	1770520173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSE A COLE MD

Provider Business Mailing Address
First Line	:	401 S ALABAMA ST STE 6B
Second Line	:
City	:	BUTTE
State	:	MT
Zip	:	59701-2358
Country	:	US
Telephone Number	:	406-723-2132
Fax Number	:	406-723-6144

Provider Business Practice Location Address
First Line	:	401 S ALABAMA ST STE 6B
Second Line	:
City	:	BUTTE
State	:	MT
Zip	:	59701-2358
Country	:	US
Telephone Number	:	406-723-2132
Fax Number	:	406-723-6144

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	01/08/2024

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Directions to “ JESSE A COLE MD” Practice Location

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