Provider Demographics
NPI:1689633182
Name:CORBETT, WILLIAM DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DAVID
Last Name:CORBETT
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 1:2662 DICK WILSON DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8723
Mailing Address - Country:US
Mailing Address - Phone:941-342-6077
Mailing Address - Fax:
Practice Address - Street 1:1961 FLOYD ST
Practice Address - Street 2:SUITE C
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2931
Practice Address - Country:US
Practice Address - Phone:941-366-2627
Practice Address - Fax:941-951-2356
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP00000460213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL87207OtherBLUE CROSS BLUE SHIELD
FL87207ZMedicare ID - Type Unspecified
FL87207OtherBLUE CROSS BLUE SHIELD