Cody Brad Mickelsen
Anesthesiologist
601 Elmwood Ave Box 604
Rochester
, New York 14642-0001
Cody Brad Mickelsen
Anesthesiologist
601 Elmwood Ave Box 604
Rochester
, New York 14642-0001
(435) 753-1600
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About
Features
Specialties
- Anesthesiologist
Languages spoken
- English
Location
First Address
- Cody Brad Mickelsen
- 274 N Main St Box 604
- Logan, UT
- Zip : 84321-3915
- Phone : (435) 753-1600
Second Address
- Cody Brad Mickelsen
- 601 Elmwood Ave Box 604
- Rochester, NY
- Zip : 14642-0001
- Fax : (585) 276-0122
- Phone : (585) 275-1384
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207L00000X | Anesthesiologist | 9806425-1205 | UT |
National Provider Identifier
| NPI | 1013159003 |
|---|---|
| Provider Name | Cody Brad Mickelsen |
| First Address | Logan, UT 84321-3915 |
| Second Address | Rochester, NY 14642-0001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/04/2009 |
| Last Update Date | 16/06/2016 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.