Provider Demographics
NPI:1083990329
Name:BENJAMIN B. COLE, O.D., P.A.
Entity Type:Organization
Organization Name:BENJAMIN B. COLE, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:785-877-5115
Mailing Address - Street 1:114 N KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:KS
Mailing Address - Zip Code:67654-2039
Mailing Address - Country:US
Mailing Address - Phone:785-877-5115
Mailing Address - Fax:
Practice Address - Street 1:114 N KANSAS AVE
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:KS
Practice Address - Zip Code:67654-2039
Practice Address - Country:US
Practice Address - Phone:785-877-5115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1865152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty