Provider Demographics
NPI:1376688846
Name:CORBIT, JOANNA LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:LYNN
Last Name:CORBIT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 CLEMENTS FERRY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29492-8325
Mailing Address - Country:US
Mailing Address - Phone:843-471-2378
Mailing Address - Fax:843-492-4806
Practice Address - Street 1:1951 CLEMENTS FERRY RD STE 203
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29492
Practice Address - Country:US
Practice Address - Phone:843-471-2378
Practice Address - Fax:843-492-4806
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5279152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCD19807Medicaid