Provider Demographics
NPI:1730166265
Name:CORDAS, DANIEL I (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:I
Last Name:CORDAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:130 DESIARD ST STE 355
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7363
Mailing Address - Country:US
Mailing Address - Phone:318-807-7875
Mailing Address - Fax:318-812-6603
Practice Address - Street 1:2516 BROADMOOR BLVD STE 1D
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-2988
Practice Address - Country:US
Practice Address - Phone:318-998-4460
Practice Address - Fax:318-998-4462
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2023-05-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA329085207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2595920Medicaid
SC23936OtherSTATE LICENSE
TNQ038220Medicaid
SC1730166265OtherNPI
SC1730166265OtherNPI