Provider Demographics
NPI:1952715369
Name:COLE, JEFFREY (OD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:COLE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5303 GLENWAY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-3706
Mailing Address - Country:US
Mailing Address - Phone:513-921-8040
Mailing Address - Fax:513-921-6483
Practice Address - Street 1:10566 LOVELAND MADEIRA RD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-8962
Practice Address - Country:US
Practice Address - Phone:513-683-3791
Practice Address - Fax:513-683-0366
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6274152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist