Basic Information
| Provider Information | |||||||||
| NPI: | 1376769794 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CODY | ||||||||
| FirstName: | PAULA | ||||||||
| MiddleName: | J. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7974 UW HEALTH CT | ||||||||
| Address2: | |||||||||
| City: | MIDDLETON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 535625531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6088295485 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2880 UNIVERSITY AVE | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537053644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082636421 | ||||||||
| FaxNumber: | 6082636547 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 01/10/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080C0008X | 52535 | WI | N | Allopathic & Osteopathic Physicians | Pediatrics | Child Abuse Pediatrics | 2080A0000X | 52535-20 | WI | Y | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine |
No ID Information.