Individual
FRED CORDER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
440 BROWNS LN, COSHOCTON, OH 43812-2044
(740) 622-0332
Mailing address
946 SEVERN DR, COSHOCTON, OH 43812-2737
(740) 622-4916
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.000341
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50.000341
PA-C LICENSE NUMBER
OH
Enumeration date
12/21/2006
Last updated
07/08/2007
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