Provider Demographics
NPI:1609859446
Name:KORBA, ALVIN N/A (MD)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:N/A
Last Name:KORBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15040
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-0040
Mailing Address - Country:US
Mailing Address - Phone:812-476-1367
Mailing Address - Fax:812-471-9282
Practice Address - Street 1:700 N BURKHARDT RD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2740
Practice Address - Country:US
Practice Address - Phone:812-474-1110
Practice Address - Fax:812-474-1303
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010272582085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0450172103Medicaid
IN110091688OtherRR MEDICARE
IN100356390Medicaid
KY64349814Medicaid
INA13949Medicare UPIN
IN100356390Medicaid
IN259540CMedicare PIN
KY64349814Medicaid