Organization
COLE FACIAL PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEPTHA NEWTON COLE M.D. (PRESIDENT)
(601) 933-2004
Entity
Organization
Contact information
Practice address
1030 N FLOWOOD DR, STE A, JACKSON, MS 39232-9532
(601) 933-2004
(601) 896-0112
Mailing address
1030 N. FLOWOOD DR., STE A, JACKSON, MS 39232
(601) 933-2004
(601) 896-0112
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
15530
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126043
—
MS
Enumeration date
10/12/2006
Last updated
08/22/2020
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