Provider Demographics
NPI:1477664464
Name:CORBIN, ARTHUR WILLIAM JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:WILLIAM
Last Name:CORBIN
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:ARTHUR
Other - Middle Name:WILLIAM
Other - Last Name:CORBIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:1001 LAKESIDE AVE E
Mailing Address - Street 2:#1200
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-1158
Mailing Address - Country:US
Mailing Address - Phone:216-479-5541
Mailing Address - Fax:216-479-5554
Practice Address - Street 1:10 SEVERANCE CIR
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1533
Practice Address - Country:US
Practice Address - Phone:216-621-5600
Practice Address - Fax:216-297-8505
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50-001119363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P30601Medicare UPIN
COPA17042Medicare ID - Type Unspecified