Provider Demographics
NPI:1265434187
Name:CODY, JAMES H (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:H
Last Name:CODY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70434-0128
Mailing Address - Country:US
Mailing Address - Phone:982-892-3766
Mailing Address - Fax:985-893-9567
Practice Address - Street 1:606 W 11TH AVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3630
Practice Address - Country:US
Practice Address - Phone:985-892-3766
Practice Address - Fax:985-893-9567
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAL011065208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1154181Medicaid
LA51373Medicare ID - Type Unspecified
LAC67416Medicare UPIN