Individual
DR. IRA JOE KODNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1040 N MASON RD, STE 120, SAINT LOUIS, MO 63141-6399
(314) 454-7177
(314) 454-5249
Mailing address
660 S EUCLID AVE, C B 8109, SAINT LOUIS, MO 63110-1010
(314) 454-7177
(314) 747-4871
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
31243
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014010181
—
MO
05
—
0280267039
—
IL
Enumeration date
07/14/2006
Last updated
10/22/2015
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