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Cody Broom
NPI 1720738099 · on the registry since 2022
Practice
- Address
- 11 Pecan Dr
Columbia, MS 39429 - Phone
- (601) 731-5717
- Fax
- (601) 633-0082
- Organisation at this address
- Jrsm Enterprises, Inc
2nd Generation Healthcare, Llc
2nd Generation Healthcare, LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 3
Additional practice sites
- 3261 Highway 49, Collins, MS
Registry record
- Primary taxonomy
- 225200000X
225200000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-06-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi