Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 23702 | MS |
N | 207YS0123X | Facial Plastic Surgeon | 23702 | MS |
NPI | 1619150349 |
---|---|
Provider Name | Dr. Cody Boyd Aull |
First Address | Meridian, MS 39302-2839 |
Second Address | Meridian, MS 39301-4016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2007 |
Last Update Date | 01/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2007034875 | STATE OF MISSOURI (01) | MO |