Provider Demographics
NPI:1114449121
Name:COLE, DAPHNE JOBILA MARCUS (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAPHNE
Middle Name:JOBILA MARCUS
Last Name:COLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:DAPHNE
Other - Middle Name:JOBILA
Other - Last Name:MARCUS-COLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:1 FREEDOM WAY
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6258
Mailing Address - Country:US
Mailing Address - Phone:404-964-4605
Mailing Address - Fax:
Practice Address - Street 1:1 FREEDOM WAY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6258
Practice Address - Country:US
Practice Address - Phone:706-733-0188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-11
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program