Individual
CORY D NAGODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 SW 119TH ST, OKLAHOMA CITY, OK 73170-4908
(405) 425-8100
(405) 425-8109
Mailing address
5300 N INDEPENDENCE AVE, SUITE 280, OKLAHOMA CITY, OK 73112-5556
(405) 425-8100
(405) 425-8109
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15316
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100736700Q
—
OK
Enumeration date
06/08/2006
Last updated
07/19/2017
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