Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 25949 | KY |
NPI | 1124092234 |
---|---|
Provider Name | Dr. Kelly K. Cole |
First Address | Lexington, KY 40504-2931 |
Second Address | Lexington, KY 40504-2931 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 02/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3937 | MEDICARE GROUP NUMBER (01) | |
64259492 | (05) | KY |
C78305 | (02) | KY |