Individual
JOSIAH AARON CODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1214 S BALTIMORE AVE, TULSA, OK 74119-2804
(918) 779-7203
Mailing address
1214 S BALTIMORE AVE, TULSA, OK 74119-2804
(918) 779-7203
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J082612843
BLUE CROSS
OK
Enumeration date
05/24/2022
Last updated
10/31/2022
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