Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD042147E | PA |
NPI | 1023012861 |
---|---|
Provider Name | Dr. Charles L Cole JR. |
First Address | Mifflinburg, PA 17844-0111 |
Second Address | Lewisburg, PA 17837-2800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 21/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012798570001 | (05) | PA |
F23272 | (02) | PA |