Provider Demographics
NPI:1861457392
Name:CORDES, MATTHEW GENE (OD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:GENE
Last Name:CORDES
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:1540 SPRING VALLEY DR
Mailing Address - Street 2:OPTOMETRY SERVICE (123)
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25704-9300
Mailing Address - Country:US
Mailing Address - Phone:304-429-6755
Mailing Address - Fax:304-429-0361
Practice Address - Street 1:8900 SE 165TH MULBERRY LANE
Practice Address - Street 2:EYE CLINIC
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162
Practice Address - Country:US
Practice Address - Phone:352-674-5000
Practice Address - Fax:352-674-5027
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2019-08-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOEG002842152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist