MEDICARE: LARRY DONALD CORDELL MD

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
1	207X00000X	Orthopaedic Surgery Physician	04-13939	KS
2	207X00000X	Orthopaedic Surgery Physician	R7372	MO
3	207X00000X	Orthopaedic Surgery Physician	38333	CO
4	207X00000X	Orthopaedic Surgery Physician	C32504	CA
5	207XS0117X	Orthopaedic Surgery of the Spine Physician	04-13939	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578567384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY DONALD CORDELL MD

Provider Business Mailing Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	MS 3017
City	:	KANSAS CITY
State	:	KS
Zip	:	66160
Country	:	US
Telephone Number	:	913-588-6100
Fax Number	:	913-588-8186

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	MS 3017
City	:	KANSAS CITY
State	:	KS
Zip	:	66160
Country	:	US
Telephone Number	:	913-588-6100
Fax Number	:	913-588-8186

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	02/27/2012

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Directions to “ LARRY DONALD CORDELL MD” Practice Location

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