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1013970540

NPI Code Detail

MEDICARE: DR. MICHAEL J KORDUS II MD

MEDICARE: DR. MICHAEL J KORDUS II 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	207P00000X	Emergency Medicine Physician	9800938	NC
2	207Q00000X	Family Medicine Physician	MD162875	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4113343	OTHER	TN	BLUE SHIELD
2	1118U	OTHER	NC	BCBS
3	P00024602	OTHER	NC	RAILROAD
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
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013970540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J KORDUS II MD

Provider Business Mailing Address
First Line	:	2859 STATE ST
Second Line	:	SUITE 101
City	:	MEDFORD
State	:	OR
Zip	:	97504-8495
Country	:	US
Telephone Number	:	541-282-6505
Fax Number	:

Provider Business Practice Location Address
First Line	:	8385 DIVISION RD STE 101
Second Line	:
City	:	WHITE CITY
State	:	OR
Zip	:	97503-1176
Country	:	US
Telephone Number	:	541-826-5853
Fax Number	:	541-826-5843

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

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	11/16/2020

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Directions to “ DR. MICHAEL J KORDUS II MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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