Cole, Ezra Lee

Cole, Ezra Lee is an individual health care provider with primary practice located at 1101 N Progress Ave , Siloam Springs AR 72761-4343. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Cole, Ezra Lee can be contacted via phone (479) 549-4228.

Contact Information

Primary practice address
1101 N Progress Ave Siloam Springs AR 72761-4343
Phone: (479) 549-4228
Fax: (479) 549-3711
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X E8536 Arkansas
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X E8536 Arkansas

Profile Details

NPI number 1851617757
LBN Legal business name Cole, Ezra Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2010
Last updated Feb 13th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851617757 NPPES
Arkansas MEDICAID 203868001
Arkansas MEDICAID 200303500B

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