Individual
JACK MARTIN COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
133 N HOWARD AVE, LANDRUM, SC 29356-1507
(864) 457-3838
(864) 560-9532
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
15903
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159036
—
SC
01
—
P01397050
RAILROAD MEDICARE
SC
01
—
SCJ0085019
MEDICARE PIN
SC
01
—
SCJ0085121
MEDICARE PIN
SC
01
—
SCJ0086067
MEDICARE PIN
SC
01
—
SCJ0086084
MEDICARE PIN
SC
01
—
SCJ0086633
MEDICARE PIN
SC
01
—
SCJ008J577
MEDICARE PIN
SC
Enumeration date
05/18/2006
Last updated
05/07/2021
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