Provider Demographics
NPI:1467406009
Name:SLEEP DISORDERS CENTER OF LONDON & CORBIN, PLLC
Entity Type:Organization
Organization Name:SLEEP DISORDERS CENTER OF LONDON & CORBIN, PLLC
Other - Org Name:SLEEP DISORDERS CENTER OF SOMERSET, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-451-0781
Mailing Address - Street 1:3121 WALL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-9007
Mailing Address - Country:US
Mailing Address - Phone:859-223-9990
Mailing Address - Fax:859-219-9454
Practice Address - Street 1:112 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-4151
Practice Address - Country:US
Practice Address - Phone:606-451-0781
Practice Address - Fax:606-451-0791
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLEEP DISORDERS CENTER OF LONDON & CORBIN, AVT.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-19
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY730105261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00138970OtherRAILROAD MEDICARE
KYP00138970OtherRAILROAD MEDICARE