Individual
EDWIN K COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
330 S 5TH ST STE 401, ENID, OK 73701-5863
(580) 249-3898
(580) 234-9625
Mailing address
PO BOX 3046, MALVERN, PA 19355-0746
(580) 249-3898
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
21807
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200000220B
—
OK
01
—
200000220C
MEDICAID OSU AJ
OK
01
—
P01319276
RR MEDICARE
OK
Enumeration date
07/21/2005
Last updated
03/30/2018
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