Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | N6346 | TX |
NPI | 1003962622 |
---|---|
Provider Name | Cody J. Hartshorn |
First Address | Granbury, TX 76048-5655 |
Second Address | Granbury, TX 76048-5655 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 11/09/2020 |