Provider Demographics
NPI:1639396583
Name:CORLE, ALDON ELISWORTH JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ALDON
Middle Name:ELISWORTH
Last Name:CORLE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1923 S UTICA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-6520
Mailing Address - Country:US
Mailing Address - Phone:918-744-2630
Mailing Address - Fax:918-744-2946
Practice Address - Street 1:3400 E FRANK PHILLIPS BLVD
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2495
Practice Address - Country:US
Practice Address - Phone:918-331-2533
Practice Address - Fax:918-331-2539
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2023-02-14
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Provider Licenses
StateLicense IDTaxonomies
OK30202207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200502110AMedicaid
AR220110001Medicaid