Provider Demographics
NPI:1134321037
Name:ERICKSON, CORINNE L (MD)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:L
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 HOWELL MILL RD NW
Mailing Address - Street 2:STE 680
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-0920
Mailing Address - Country:US
Mailing Address - Phone:404-352-1730
Mailing Address - Fax:404-352-6907
Practice Address - Street 1:1800 HOWELL MILL RD NW
Practice Address - Street 2:STE 680
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-0920
Practice Address - Country:US
Practice Address - Phone:404-352-1730
Practice Address - Fax:404-352-6907
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA065765174400000X, 207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No174400000XOther Service ProvidersSpecialist
No207N00000XAllopathic & Osteopathic PhysiciansDermatology