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General NPI Number Information
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NPI Number | 1770508327
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Entity Type | Individual
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Provider Name | ROBERT L CORDER JR. MD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 01/26/2022
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Provider Practice Location Address
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Address Line | 902 EDMOND ST STE 203
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City | SAINT JOSEPH
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State | MO
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Zip | 64501-2762
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Country | US
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Telephone | 816-364-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 902 EDMOND ST STE 203
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City | SAINT JOSEPH
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State | MO
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Zip | 64501-2762
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Country | US
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Telephone | 816-364-4300
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Fax | 816-279-8148
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | R6429
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | R6429
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License Number State | MO
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