Provider Demographics
NPI:1316091416
Name:LAY, CODY MICHAEL (OD)
Entity type:Individual
Prefix:DR
First Name:CODY
Middle Name:MICHAEL
Last Name:LAY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6620 MEURSAULT DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9591
Mailing Address - Country:US
Mailing Address - Phone:402-328-9849
Mailing Address - Fax:
Practice Address - Street 1:818 E 23RD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-3866
Practice Address - Country:US
Practice Address - Phone:402-564-0474
Practice Address - Fax:402-562-5488
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1205152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist