Provider Demographics
NPI:1437748811
Name:MAY, CODY THOMAS (KCSA, CSFA)
Entity Type:Individual
Prefix:MR
First Name:CODY
Middle Name:THOMAS
Last Name:MAY
Suffix:
Gender:M
Credentials:KCSA, CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 SHEARWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-4156
Mailing Address - Country:US
Mailing Address - Phone:785-248-0313
Mailing Address - Fax:
Practice Address - Street 1:224 SHEARWOOD AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-4156
Practice Address - Country:US
Practice Address - Phone:785-248-0313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTSA011246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant