Provider Demographics
NPI:1013549930
Name:CORBITT, WILLIAM CELLAIGH (PA)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CELLAIGH
Last Name:CORBITT
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:210 VILLAGE CENTER BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-6706
Mailing Address - Country:US
Mailing Address - Phone:843-353-3460
Mailing Address - Fax:
Practice Address - Street 1:210 VILLAGE CENTER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-6706
Practice Address - Country:US
Practice Address - Phone:433-533-4608
Practice Address - Fax:843-353-3461
Is Sole Proprietor?:No
Enumeration Date:2020-02-08
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program