Anderson, Cody Clarke

Anderson, Cody Clarke is an sole proprietor health care provider with primary practice located at 241 Kelley St , Lake City SC 29560-2446. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Anderson, Cody Clarke can be contacted via phone (843) 519-2399.

Contact Information

Primary practice address
241 Kelley St Lake City SC 29560-2446
Phone: (843) 519-2399
Fax: (843) 519-0234
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 061.0000023 Vermont
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 713 South Carolina

Profile Details

NPI number 1871023960
LBN Legal business name Anderson, Cody Clarke
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 12th, 2017
Last updated Nov 12th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871023960 NPPES
South Carolina MEDICAID SCJ236

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