Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | M14785 | ID |
Y | 2086S0122X | Plastic and Reconstructive Surgery | M14785 | ID |
NPI | 1023337631 |
---|---|
Provider Name | Dr. Patrick Cole |
First Address | Boise, ID 83711-4655 |
Second Address | Boise, ID 83706-1257 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2010 |
Last Update Date | 10/12/2019 |