Provider Demographics
NPI:1033347158
Name:CORRY, MARK WILLIS (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:WILLIS
Last Name:CORRY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1303 N MAIN ST.
Mailing Address - Street 2:SUITE C
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721
Mailing Address - Country:US
Mailing Address - Phone:435-868-5500
Mailing Address - Fax:435-868-5538
Practice Address - Street 1:1303 N MAIN ST.
Practice Address - Street 2:SUITE C
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721
Practice Address - Country:US
Practice Address - Phone:435-868-5500
Practice Address - Fax:435-868-5538
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2012-08-31
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Provider Licenses
StateLicense IDTaxonomies
UT7747183-1205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine