Provider Demographics
NPI:1578566949
Name:KORPINEN, JARYL G (DPM)
Entity Type:Individual
Prefix:
First Name:JARYL
Middle Name:G
Last Name:KORPINEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8135 FOREST LN # 515057
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2472
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6309 PRESTON RD
Practice Address - Street 2:STE 1200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2606
Practice Address - Country:US
Practice Address - Phone:972-424-8999
Practice Address - Fax:972-612-3926
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1539213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7129311OtherAETNA
TX0090LJOtherBLUE CROSS BLUE SHIELD
TX611235Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE
TX7129311OtherAETNA
TX5456170001Medicare NSC