Provider Demographics
NPI:1124482666
Name:KODIYAN, JOYSON (MD)
Entity type:Individual
Prefix:
First Name:JOYSON
Middle Name:
Last Name:KODIYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 MEMORIAL MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-5111
Mailing Address - Country:US
Mailing Address - Phone:386-231-4061
Mailing Address - Fax:386-672-4960
Practice Address - Street 1:224 MEMORIAL MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5111
Practice Address - Country:US
Practice Address - Phone:386-231-4061
Practice Address - Fax:386-672-4960
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV305792085R0001X
FLME1608082085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology