Provider Demographics
NPI:1831205764
Name:COLE, NORMAN G (MD)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:G
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 1:1015 E. PIKES PEAK AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903
Mailing Address - Country:US
Mailing Address - Phone:719-473-2424
Mailing Address - Fax:719-227-1475
Practice Address - Street 1:1015 E PIKES PEAK AVE
Practice Address - Street 2:STE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-3782
Practice Address - Country:US
Practice Address - Phone:719-473-2424
Practice Address - Fax:719-227-1475
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO22104174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO19281Medicare ID - Type Unspecified
COD24034Medicare UPIN