Provider Demographics
NPI:1326267469
Name:COLE, CHRISTOPHER BRANNON (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:BRANNON
Last Name:COLE
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 2699
Mailing Address - Street 2:ATTN SHMG/HPE
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-682-6122
Mailing Address - Fax:850-682-5917
Practice Address - Street 1:550 REDSTONE AVE W STE 200A
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32536-6428
Practice Address - Country:US
Practice Address - Phone:850-682-0383
Practice Address - Fax:850-682-9278
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2019-01-14
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Provider Licenses
StateLicense IDTaxonomies
FLPA9109797363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant