Kodner, Ira Joe

Kodner, Ira Joe is an individual health care provider with primary practice located at 1040 N Mason Rd Ste 120, Saint Louis MO 63141-6399. He recently has only one registered license in Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, which is considered as his primary health care specialty. Kodner, Ira Joe can be contacted via phone (314) 454-7177.

Contact Information

Primary practice address
1040 N Mason Rd Ste 120 Saint Louis MO 63141-6399
Phone: (314) 454-7177
Fax: (314) 454-5249
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 31243 Missouri

Profile Details

NPI number 1760408983
LBN Legal business name Kodner, Ira Joe
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Oct 22nd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760408983 NPPES
Illinois MEDICAID 0280267039
Illinois MEDICAID 014010181

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