Provider Demographics
NPI:1760483275
Name:CORBY, GARY ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:ALAN
Last Name:CORBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:SEELYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47878-0399
Mailing Address - Country:US
Mailing Address - Phone:812-442-7476
Mailing Address - Fax:812-442-7545
Practice Address - Street 1:4018 WESTOAK VALLEY DR
Practice Address - Street 2:
Practice Address - City:LANESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47136-9475
Practice Address - Country:US
Practice Address - Phone:812-442-7476
Practice Address - Fax:812-442-7545
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01045450A208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200223130OtherMEDICAID
INP00212153OtherTRICARE
IN000000360341OtherBLUE CROSS BLUE SHIELD
IN607877500OtherBLACK LUNG
INP00212153OtherRAILROAD MEDICARE
INP00212153OtherPALMETTO TRICARE
IN607877500OtherBLACK LUNG