Provider Demographics
NPI:1235134990
Name:CORS, WILLIAM KEVIN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:KEVIN
Last Name:CORS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6 CANADA GOOSE DR
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-3105
Mailing Address - Country:US
Mailing Address - Phone:908-850-4870
Mailing Address - Fax:908-850-1808
Practice Address - Street 1:6 CANADA GOOSE DR
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-3105
Practice Address - Country:US
Practice Address - Phone:908-850-4870
Practice Address - Fax:908-850-1808
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA031911002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ41275984BMedicaid
C58557Medicare UPIN