Individual
CODY LOOMIS MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1485 N TURQUOISE DR STE 200, FLAGSTAFF, AZ 86001
(928) 774-7757
(928) 226-3071
Mailing address
1485 N TURQUOISE DR STE 200, FLAGSTAFF, AZ 86001-2000
(928) 774-7757
(928) 226-3071
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
55377
AZ
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
55377
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
344235
—
AZ
Enumeration date
04/09/2012
Last updated
08/24/2018
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