Individual provider · NPI-1

Dr. Ira Joe Kodner, MD

Colon & Rectal Surgery · Saint Louis, MO

NPI number1760408983
StatusActive
Last updated in NPPESOct 22, 2015

Details

NPI
1760408983
Entity type
Individual (NPI-1)
Name
Dr. Ira Joe Kodner
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jul 14, 2006
Last updated
Oct 22, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208C00000X Colon & Rectal Surgery31243MOYes

Practice location

1040 N Mason Rd
Ste 120
Saint Louis, MO 63141-6399

Phone 314-454-7177 · Fax 314-454-5249

Mailing address

660 S Euclid Ave
C B 8109
Saint Louis, MO 63110-1010

Phone 314-454-7177 · Fax 314-747-4871

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