Kody Medical PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

23700 Issued in AZ

Legal business name

KODY MEDICAL PC

Practice address

11627 N 12TH PL
Phoenix, AZ 85020-1222

Phone

(602) 799-2133

Fax

(602) 997-1418

NPI assigned

Feb 15, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark Alexander Mathurin, MD

Title

Ceo

Phone

(602) 799-2133

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351814400000",
    "number": "1033482435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11627 N 12TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850201222",
            "telephone_number": "602-799-2133",
            "fax_number": "602-997-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11627 N 12TH PL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850201222",
            "telephone_number": "602-799-2133",
            "fax_number": "602-997-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KODY MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-11-02",
        "status": "A",
        "authorized_official_last_name": "MATHURIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-799-2133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "AZ",
            "license": "23700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "23700",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Koch
• Candice M. Kochis
• Anna Louise Kock, RN
• Betsy Kocsis, R.N., M.S.N.
• Rahul G Kode, DDS
• Logan Kodysz, NP
• Mary Koehl, LCSW
• Katherine Koehler
• Lindsay Koehler
• Monika Koehler

• General Practice Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.