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Individual

STANLEY R KORDISCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4150 NELSON RD, BLDG C-10, LAKE CHARLES, LA 70605-4148
(337) 474-0653
(337) 474-0639
Mailing address
4150 NELSON RD, BLDG C-10, LAKE CHARLES, LA 70605-4148
(337) 474-0653
(337) 474-0639

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
013813
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1303160
LA
Enumeration date
03/25/2006
Last updated
10/31/2007
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