Provider Demographics
NPI:1366496275
Name:COLE, RICHARD L (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:COLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2845 SUMMER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3812
Mailing Address - Country:US
Mailing Address - Phone:901-377-2340
Mailing Address - Fax:901-373-4570
Practice Address - Street 1:2845 SUMMER OAKS DR
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-3812
Practice Address - Country:US
Practice Address - Phone:901-377-2340
Practice Address - Fax:901-373-4570
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC196111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN23032OtherBCBS ID
TN23032OtherBCBS ID
TNT74810Medicare UPIN
TN3671720Medicare PIN