Richard Cordle, MD | |
4348 Electric Rd, Roanoke, VA 24018-0720 | |
(540) 769-0976 | |
(540) 857-5391 |
Full Name | Richard Cordle |
---|---|
Gender | Male |
Speciality | Pediatrics - Pediatric Gastroenterology |
Location | 4348 Electric Rd, Roanoke, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356313241 | NPI | - | NPPES |
010383722 | Medicaid | VA | |
1356313241 | Medicaid | VA | |
6702708 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 0101-233252 (Virginia) | Secondary |
2080P0206X | Pediatrics - Pediatric Gastroenterology | 0101-233252 (Virginia) | Primary |
Entity Name | Carilion Healthcare Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1447206370 PECOS PAC ID: 5890607253 Enrollment ID: O20031106000273 |
Entity Name | Carilion Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1730123472 PECOS PAC ID: 9830096585 Enrollment ID: O20040107000472 |
Entity Name | Carilion Giles Community Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194718304 PECOS PAC ID: 3678670221 Enrollment ID: O20070516000487 |
Mailing Address | Practice Location Address |
---|---|
Richard Cordle, MD 3027 Circle Dr Sw, Roanoke, VA 24018-2107 Ph: () - | Richard Cordle, MD 4348 Electric Rd, Roanoke, VA 24018-0720 Ph: (540) 769-0976 |
Camron L Johnson Privitera, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 21 Highland Ave Se, Ste 100, Roanoke, VA 24013 Phone: 540-344-9213 Fax: 540-345-7559 | |
Robert C Gard, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 21 Highland Ave Se, Ste 100, Roanoke, VA 24013 Phone: 540-344-9213 Fax: 540-345-7559 | |
Joseph Tamez, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 4348 Electric Rd, Roanoke, VA 24018 Phone: 540-769-0976 Fax: 540-857-5393 | |
Kaitlyn Bixel, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1906 Belleview Ave Se, Roanoke, VA 24014 Phone: 540-224-4635 Fax: 540-985-9099 | |
Susan Smith, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 89 Summers Way, Roanoke, VA 24019 Phone: 540-992-1251 | |
Dr. Erinn E Hokanson, NP Pediatrics Medicare: Medicare Enrolled Practice Location: 4348 Electric Rd, Roanoke, VA 24018 Phone: 540-769-0975 Fax: 540-772-8219 | |
Dr. Timothy H Hartzog, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1906 Belleview Ave Se, Roanoke, VA 24014 Phone: 540-224-4635 Fax: 540-529-7864 |