Individual
DR. PAUL ROGER CORDTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1599 CHOCTAW LOOP, FORT CAMPBELL, KY 42223-1043
(270) 798-8041
(270) 798-8838
Mailing address
1599 CHOCTAW LOOP, FORT CAMPBELL, KY 42223-1043
(270) 798-8041
(270) 798-8838
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
87-35
NM
2086S0102X
Surgical Critical Care Physician
87-35
NM
2086S0129X
Vascular Surgery Physician
87-35
NM
Other
Enumeration date
01/16/2006
Last updated
03/22/2012
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