Provider Demographics
NPI:1518052067
Name:COLE, JAMES P (BS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:COLE
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE M273
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-381-0180
Mailing Address - Fax:269-381-7347
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:M273
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-381-0180
Practice Address - Fax:269-381-7347
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147000875231H00000X
MI1601000568231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI640C903140OtherBCBS
MI0C97625160Medicare PIN