Healthcare Provider Details

I. General information

NPI: 1538975255
Provider Name (Legal Business Name): CODY DEVIN VOYLES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2024
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 UNION AVE
MEMPHIS TN
38104-3725
US

IV. Provider business mailing address

1661 INTERNATIONAL DR STE 400
MEMPHIS TN
38120-1431
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax: 772-675-9100
Mailing address:
  • Phone: 662-420-7735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2207
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: