Provider Demographics
NPI:1629463674
Name:DAVIS, CODY HAMILTON (DO)
Entity Type:Individual
Prefix:DR
First Name:CODY
Middle Name:HAMILTON
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7322 MANATEE AVE W
Mailing Address - Street 2:#220
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209
Mailing Address - Country:US
Mailing Address - Phone:716-795-2422
Mailing Address - Fax:
Practice Address - Street 1:1370 W D ST
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3506
Practice Address - Country:US
Practice Address - Phone:336-716-2255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO2854208M00000X
WI135-321208M00000X
TN4153208M00000X
NVCL0099208M00000X
MS26093208M00000X
MN68188208M00000X
GA81937208M00000X
FLOS14365208M00000X
CODR.0062191208M00000X
ALDO.2329208M00000X
WV3488208M00000X
MT68670208M00000X
NC2018-02762208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist