Provider Demographics
NPI:1265470900
Name:COLE, ELIZABETH DIANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:DIANNE
Last Name:COLE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3840 GAULT AVE N
Mailing Address - Street 2:
Mailing Address - City:FORT PAYNE
Mailing Address - State:AL
Mailing Address - Zip Code:35967-5211
Mailing Address - Country:US
Mailing Address - Phone:256-844-4975
Mailing Address - Fax:256-844-4978
Practice Address - Street 1:3840 GAULT AVE N
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35967-5211
Practice Address - Country:US
Practice Address - Phone:256-844-4975
Practice Address - Fax:256-844-4978
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2013-12-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS18226207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine