Provider Demographics
NPI:1003646209
Name:COLE, RAYMOND PHILIP (KY STATE PARAMEDIC)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:PHILIP
Last Name:COLE
Suffix:
Gender:M
Credentials:KY STATE PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 SHADYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BOONEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41314-7448
Mailing Address - Country:US
Mailing Address - Phone:606-599-7999
Mailing Address - Fax:
Practice Address - Street 1:18 WALNUT ST
Practice Address - Street 2:
Practice Address - City:BEATTYVILLE
Practice Address - State:KY
Practice Address - Zip Code:41311-6400
Practice Address - Country:US
Practice Address - Phone:606-599-7999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1049977146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic