Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 6907 | TN |
N | 207RS0012X | Sleep Medicine | 6907 | TN |
NPI | 1023046737 |
---|---|
Provider Name | Charles Pittman Cole |
First Address | Johnson City, TN 37604-6008 |
Second Address | Johnson City, TN 37604-6008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 28/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3172391 | (05) | TN |
B03529 | (02) | TN |