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NPI Code Detail

MEDICARE: JOHN F CORDOVA M.D.

MEDICARE: JOHN F CORDOVA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician61160WI
2207RC0200XCritical Care Medicine (Internal Medicine) Physician61160WI

General Provider Information

NPI Number : 1073510731
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN F CORDOVA M.D.
Provider Business Mailing Address
First Line : 1000 N OAK AVE
Second Line :
City : MARSHFIELD
State : WI
Zip : 54449-5703
Country : US
Telephone Number : 715-387-5511
Fax Number :
Provider Business Practice Location Address
First Line : 1000 N OAK AVE
Second Line :
City : MARSHFIELD
State : WI
Zip : 54449-5703
Country : US
Telephone Number : 715-387-5511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 11/17/2022

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