Provider Demographics
NPI:1013972561
Name:COLE, SYLVIA A (MD)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:A
Last Name:COLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 950202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0202
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:825 BARRET AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-1743
Practice Address - Country:US
Practice Address - Phone:502-540-7200
Practice Address - Fax:502-540-7207
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34656207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY110186559OtherRAILROAD MEDICARE
KY64007545Medicaid
KY00000074657OtherANTHEM / NCMA
KY1103710OtherPASSPORT / NCMA
KY000026447BOtherHUMANA / NCMA
IN200270750Medicaid
KY2436382000OtherPASSPORT ADVANTAGE / NCMA
KY008912OtherSIHO / NCMA
KY000026447BOtherHUMANA / NCMA
KY64007545Medicaid