| Dr Cody Blackwelder, MD | |
|
1200 S Farmerville St, Ruston, LA 71270-5941 | |
| (318) 255-3690 | |
| Not Available |
| Full Name | Dr Cody Blackwelder |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 6 Years |
| Location | 1200 S Farmerville St, Ruston, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548824873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 341995 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Northern Louisiana Medical Center | Ruston, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Green Clinic Llc | 4789668831 | 46 |
| Entity Name | Green Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831178755 PECOS PAC ID: 4789668831 Enrollment ID: O20040616000177 |
| Entity Name | Northern Louisiana Emergency Physicians, Llp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588828172 PECOS PAC ID: 9638246846 Enrollment ID: O20080930000036 |
| Entity Name | Clhg-winn, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629391628 PECOS PAC ID: 6002198736 Enrollment ID: O20190103000659 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Cody Blackwelder, MD 1200 S Farmerville St, Ruston, LA 71270-5941 Ph: (318) 255-3690 | Dr Cody Blackwelder, MD 1200 S Farmerville St, Ruston, LA 71270-5941 Ph: (318) 255-3690 |
Mr. Derek R Mcclusky, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1200 S Farmerville St, Ruston, LA 71270 Phone: 318-255-3690 | |
Mr. Greene Butler, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 1200 S Farmerville St, Ruston, LA 71270 Phone: 318-255-3690 | |
Kerry Wayne Byrnes, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1200 S Farmerville St, Ruston, LA 71270 Phone: 318-255-9630 |