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Individual

MR. CODY GUIDRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1514 JEFFERSON HWY, JEFFERSON, LA 70121-2429
(504) 842-3000
Mailing address
233 E 14TH PL, LAROSE, LA 70373-2039
(985) 278-1916

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
340354
LA

Other

Enumeration date
07/19/2024
Last updated
07/19/2024
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