Individual
EZRA LEE COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1101 N PROGRESS AVE, SILOAM SPRINGS, AR 72761-4343
(479) 549-4228
(479) 549-3711
Mailing address
PO BOX 516, SILOAM SPRINGS, AR 72761-0516
(479) 549-4228
(479) 549-3711
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
E8536
AR
208000000X
Pediatrics Physician
Primary
E8536
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200303500B
—
OK
05
—
203868001
—
AR
Enumeration date
04/16/2010
Last updated
02/13/2015
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