Individual
MR. JAIME MIGUEL CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1442 E BRIDGE ST, BREAUX BRIDGE, LA 70517
(337) 332-2428
(337) 332-6977
Mailing address
1442 E BRIDGE ST, BREAUX BRIDGE, LA 70517
(337) 332-2428
(337) 332-6977
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
022843
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1490725
—
LA
Enumeration date
08/29/2006
Last updated
07/08/2007
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