Provider Demographics
NPI:1063092724
Name:KORDSMEIER, JOSEPH ANDREW (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANDREW
Last Name:KORDSMEIER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 RILEY CIR
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:AR
Mailing Address - Zip Code:72921-4050
Mailing Address - Country:US
Mailing Address - Phone:501-208-3497
Mailing Address - Fax:
Practice Address - Street 1:171 DR TT LEWIS CIR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:MS
Practice Address - Zip Code:38921-2400
Practice Address - Country:US
Practice Address - Phone:662-647-5535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MS30440207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program