Individual
DR. CORD TANNER LANDRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C., PA-C
Contact information
Practice address
905 COLONY DR, ADA, OK 74820-2329
(580) 436-5111
(580) 436-1159
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
(580) 925-3286
(580) 925-9149
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3744
OK
363A00000X
Physician Assistant
Primary
3003
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3003
OKLAHOMA BOARD OF MEDICAL LICENSURE
OK
Enumeration date
10/13/2006
Last updated
11/22/2021
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