Provider Demographics
NPI:1750532651
Name:COLE, CAROLYN NEUHOFF (DPM)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:NEUHOFF
Last Name:COLE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:ROSE
Other - Last Name:NEUHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:1481 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2803
Mailing Address - Country:US
Mailing Address - Phone:317-988-9951
Mailing Address - Fax:
Practice Address - Street 1:1481 W 10TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2803
Practice Address - Country:US
Practice Address - Phone:317-988-9951
Practice Address - Fax:317-988-5346
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0699213ES0103X
IN07001190A213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery