Provider Demographics
NPI:1225031230
Name:COLE, GEORGE MARTIN (DO)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:MARTIN
Last Name:COLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50728
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-0728
Mailing Address - Country:US
Mailing Address - Phone:180-637-9777
Mailing Address - Fax:180-635-2659
Practice Address - Street 1:2300 BELL ST
Practice Address - Street 2:STE 20
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4632
Practice Address - Country:US
Practice Address - Phone:180-637-9770
Practice Address - Fax:180-635-2659
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5175207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097283Medicare UPIN
TX00D576Medicare ID - Type Unspecified