| Cody W Davis, Pa | |
|
910 W Main Pl Ste I Russellville AR 72801-3510 | |
| (479) 453-9964 | |
| Not Available |
| Full Name | Cody W Davis, Pa |
|---|---|
| Speciality | Counselor - Professional |
| Location | 910 W Main Pl Ste I, Russellville, Arkansas |
| Authorized Official Name and Position | Cody W Davis (PRESIDENT) |
| Authorized Official Contact | 4794539964 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cody W Davis, Pa 910 W Main Pl Ste I Russellville AR 72801-3510 Ph: (479) 453-9964 | Cody W Davis, Pa 910 W Main Pl Ste I Russellville AR 72801-3510 Ph: (479) 453-9964 |
| NPI Number | 1821770421 |
|---|---|
| Provider Enumeration Date | 08/02/2023 |
| Last Update Date | 04/18/2024 |
| Certification Date | 04/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821770421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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