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Organization

PERRY JC MD PA

Active
Other names
THE COLE CLINIC
Organization subpart
No

Provider details

NPI number
Authorized official
PERRY J COLE MD (OWNER)
(904) 733-0099
Entity
Organization

Contact information

Practice address
7999 PHILIPS HWY, STE 302, JACKSONVILLE, FL 32256-4443
(904) 733-0099
(904) 733-0070
Mailing address
PO BOX 3123, ST AUGUSTINE, FL 32085-3123
(904) 824-4990
(904) 824-2226

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
ME83999
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0014P
BCBS
FL
05
002608400
FL
01
614424600
OWCP - FECA
FL
01
7511404
AETNA
FL
Enumeration date
05/29/2009
Last updated
05/27/2011
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