Individual
KELLY L COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
121 E MAIN ST, PROVIDENCE, KY 42450-1268
(270) 667-2023
(270) 667-7518
Mailing address
PO BOX 310, PROVIDENCE, KY 42450-0310
(270) 667-2023
(270) 667-7518
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02437
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000043968
ANTHEM BLUE CROSS & BLUE
KY
01
—
027299800
BLACK LUNG
—
05
—
1103582
—
KY
01
—
1386132
THE FUNDS ID
—
05
—
64024375
—
KY
Enumeration date
02/14/2006
Last updated
11/20/2007
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