Individual
DR. CODY BLACKWELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 S FARMERVILLE ST, RUSTON, LA 71270-5941
(318) 255-3690
Mailing address
1200 S FARMERVILLE ST, RUSTON, LA 71270-5941
(318) 255-3690
(318) 232-1571
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
341995
LA
Other
Enumeration date
04/22/2019
Last updated
10/10/2024
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