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NPI Code Detail

MEDICARE: CODY GLENN WHITE D.O.

MEDICARE: CODY GLENN WHITE D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianOT016148PA
2207Q00000XFamily Medicine PhysicianW4993TX

General Provider Information

NPI Number : 1528477213
Entity Type Code : Individual
Provider Name (Legal Business Name) : CODY GLENN WHITE D.O.
Provider Business Mailing Address
First Line : PO BOX 959
Second Line :
City : COLUMBUS
State : MT
Zip : 59019-0959
Country : US
Telephone Number : 406-322-1000
Fax Number :
Provider Business Practice Location Address
First Line : 710 11TH ST N
Second Line :
City : COLUMBUS
State : MT
Zip : 59019-7215
Country : US
Telephone Number : 406-322-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2014
Last Update Date : 05/06/2026

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Directions to “ CODY GLENN WHITE D.O.” Practice Location

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