1841564853 NPI number — CODY E MCNEELY DPT

Table of content: DR. THOMAS FRANKLIN WILKINSON DDS (NPI 1043219926)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841564853 NPI number — CODY E MCNEELY DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCNEELY
Provider First Name:
CODY
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JOYCE
Provider Other First Name:
CODY
Provider Other Middle Name:
E
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841564853
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/11/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5200 COMMERCE CROSSING, 3RD FLOOR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40229
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-253-4924
Provider Business Mailing Address Fax Number:
502-489-5750

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12411 HYMEADOW DR
Provider Second Line Business Practice Location Address:
BLDG 3, STE 3B
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78750-1874
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-335-9300
Provider Business Practice Location Address Fax Number:
512-335-9301
Provider Enumeration Date:
03/08/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1215498 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com