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Individual

MR. JEPTHA NEWTON COLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1030 N FLOWOOD DR, JACKSON, MS 39232-9532
(601) 933-2004
(601) 896-0112
Mailing address
204 E LAYFAIR DR, FLOWOOD, MS 39232-9526
(601) 933-2004
(601) 896-0112

Taxonomy

Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
15530
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00126043
MS
Enumeration date
10/03/2006
Last updated
08/12/2019
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