Provider Demographics
NPI:1457445181
Name:COLE, RICHARD D (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:D
Last Name:COLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:74 BEATTY SPUR LN
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-9623
Mailing Address - Country:US
Mailing Address - Phone:307-750-2238
Mailing Address - Fax:307-750-2239
Practice Address - Street 1:1898 FORT RD
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-8320
Practice Address - Country:US
Practice Address - Phone:307-672-3473
Practice Address - Fax:307-672-1639
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY5561A207P00000X
UT180239-1204207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine