Provider Demographics
NPI:1710219084
Name:DONNA M CORDER MD PA
Entity Type:Organization
Organization Name:DONNA M CORDER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CORDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-432-4733
Mailing Address - Street 1:3421 N 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-4008
Mailing Address - Country:US
Mailing Address - Phone:850-432-4733
Mailing Address - Fax:850-432-4788
Practice Address - Street 1:3421 N 12TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-4008
Practice Address - Country:US
Practice Address - Phone:850-432-4733
Practice Address - Fax:850-432-4788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64088207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty