NPI 1033482435

Kody Medical PC

Organisation General Practice Physician Phoenix, AZ

Practice location

Address: 11627 N 12th Pl, Phoenix, AZ 85020-1222
Phone: (602) 799-2133
Fax: (602) 997-1418

Authorised official

Name: Mark Alexander Mathurin
Title: Ceo
Phone: (602) 799-2133

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 23700 (AZ)

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Registry record

NPI: 1033482435
Entity type: Organization
NPI issued: 15 Feb 2012
Record last updated: 2 Nov 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.