Provider Demographics
NPI:1710124250
Name:MCCORKLE, BRIAN H (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:H
Last Name:MCCORKLE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-7267
Mailing Address - Country:US
Mailing Address - Phone:781-641-0901
Mailing Address - Fax:
Practice Address - Street 1:185 BAY STATE RD
Practice Address - Street 2:DANIELSEN INSTITUTE AT BOSTON UNIVERSITY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-1506
Practice Address - Country:US
Practice Address - Phone:617-358-2969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program