Provider Demographics
NPI:1104019272
Name:CORSON, ANN F (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:F
Last Name:CORSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:731 STREET ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:COCHRANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19330-9469
Mailing Address - Country:US
Mailing Address - Phone:610-869-0270
Mailing Address - Fax:610-869-0271
Practice Address - Street 1:731 STREET ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:COCHRANVILLE
Practice Address - State:PA
Practice Address - Zip Code:19330-9469
Practice Address - Country:US
Practice Address - Phone:610-869-0270
Practice Address - Fax:610-869-0271
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD030103E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E78025Medicare UPIN
PA077687Medicare Oscar/Certification