Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 420010290 | VT |
Y | 2081P2900X | Pain Medicine | 037509 | GA |
N | 2081P2900X | Pain Medicine | 420010290 | VT |
N | 2081S0010X | Sports Medicine | 420010290 | VT |
N | 213ES0000X | Sports Medicine | 420010290 | VT |
NPI | 1265457261 |
---|---|
Provider Name | Rayden Chandler Cody |
First Address | Atlanta, GA 30342-1703 |
Second Address | Atlanta, GA 30342-1703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 20/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02193933 | (05) | NY |
1008098 | (05) | VT |
F67922 | (02) | VT |