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Individual

JIMMY D CODY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
744 W 9TH ST, TULSA, OK 74127-9020
(918) 587-2561
Mailing address
DEPT. 672, TULSA, OK 74182-0001
(866) 321-8433

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
2338
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100112460A
OK
05
100228470B
OK
Enumeration date
10/12/2005
Last updated
04/23/2009
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