Provider Demographics
NPI:1972599470
Name:CORDER, DONNA M (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:M
Last Name:CORDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2020
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36533-2020
Mailing Address - Country:US
Mailing Address - Phone:251-990-3937
Mailing Address - Fax:251-990-9990
Practice Address - Street 1:907 GARDEN GATE CIR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8629
Practice Address - Country:US
Practice Address - Phone:251-990-3937
Practice Address - Fax:251-990-9990
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0064088207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F31991Medicare UPIN
FL18818Medicare PIN