Provider Demographics
NPI:1598812463
Name:COLE, MICHAEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:E
Last Name:COLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 N HICKORY AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2428
Mailing Address - Country:US
Mailing Address - Phone:931-646-1900
Mailing Address - Fax:931-372-8839
Practice Address - Street 1:317 N HICKORY AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2428
Practice Address - Country:US
Practice Address - Phone:931-646-1900
Practice Address - Fax:931-372-8839
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43612207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1506023Medicaid
TN3001634Medicare PIN