Provider Demographics
NPI:1437446309
Name:HILL, CODY RYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CODY
Middle Name:RYAN
Last Name:HILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1051 GAUSE BLVD STE 290
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2900
Mailing Address - Country:US
Mailing Address - Phone:985-280-7456
Mailing Address - Fax:985-280-6556
Practice Address - Street 1:1051 GAUSE BLVD STE 290
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2900
Practice Address - Country:US
Practice Address - Phone:985-280-7456
Practice Address - Fax:985-280-6556
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA301482207RP1001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty