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Organization
VINCE J. CODA AND ASSOCIATES
Active
Organization
VINCE J. CODA AND ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT J CODA DPM (OWNER)
(260) 347-2833
Entity
Organization
Contact information
Practice address
410 E MITCHELL ST, KENDALLVILLE, IN 46755-1890
(260) 347-2833
Mailing address
410 E MITCHELL ST, P O BOX 545, KENDALLVILLE, IN 46755-1890
(260) 347-2833
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
07000383A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY
IN
01
—
000000077974
ANTHEM BLUE CROSS BLUE SH
IN
01
—
07000383A
INDIANA STATE MED LICENSE
IN
Enumeration date
05/21/2007
Last updated
05/21/2020
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