Provider Demographics
NPI:1770004988
Name:LAYNE, KODI (DO)
Entity Type:Individual
Prefix:
First Name:KODI
Middle Name:
Last Name:LAYNE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1709 KY ROUTE 321 STE 3
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-9097
Mailing Address - Country:US
Mailing Address - Phone:606-886-8546
Mailing Address - Fax:
Practice Address - Street 1:50 WEDDINGTON BRANCH RD STE B
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-3296
Practice Address - Country:US
Practice Address - Phone:606-637-6377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV3353207Q00000X
KY05105207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine