Provider Demographics
NPI:1144508797
Name:HOSS, CODY L (OD)
Entity type:Individual
Prefix:DR
First Name:CODY
Middle Name:L
Last Name:HOSS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 W GRAND AVE
Mailing Address - Street 2:STE 111
Mailing Address - City:HAYSVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67060-1270
Mailing Address - Country:US
Mailing Address - Phone:316-253-8653
Mailing Address - Fax:
Practice Address - Street 1:1425 W GRAND AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:HAYSVILLE
Practice Address - State:KS
Practice Address - Zip Code:67060-1269
Practice Address - Country:US
Practice Address - Phone:316-858-4558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1898152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist