Basic Information
| Provider Information | |||||||||
| NPI: | 1629463674 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAVIS | ||||||||
| FirstName: | CODY | ||||||||
| MiddleName: | HAMILTON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7322 MANATEE AVE W | ||||||||
| Address2: | #220 | ||||||||
| City: | BRADENTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7167952422 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1370 W D ST | ||||||||
| Address2: | |||||||||
| City: | NORTH WILKESBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286593506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3367162255 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2015 | ||||||||
| LastUpdateDate: | 03/04/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | DO2854 | ME | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 135-321 | WI | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 4153 | TN | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | CL0099 | NV | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 26093 | MS | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 68188 | MN | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 81937 | GA | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | OS14365 | FL | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | DR.0062191 | CO | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | DO.2329 | AL | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 3488 | WV | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 68670 | MT | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 2018-02762 | NC | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.