Provider Demographics
NPI:1790861292
Name:CORLEY, LUTHER FRANKLIN III (MD)
Entity Type:Individual
Prefix:DR
First Name:LUTHER
Middle Name:FRANKLIN
Last Name:CORLEY
Suffix:III
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 1:1104 MONROE ST SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-265-5864
Mailing Address - Fax:256-265-5865
Practice Address - Street 1:1104 MONROE ST SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5029
Practice Address - Country:US
Practice Address - Phone:256-265-5864
Practice Address - Fax:256-265-5865
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00009310207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102I290249OtherMEDICARE PTAN
AL4003518OtherAETNA PROVIDER NUMBER
AL181460Medicaid
AL4003518OtherAETNA PROVIDER NUMBER
AL4003518OtherAETNA PROVIDER NUMBER
AL000014350Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
TN4401083Medicaid
AL4810020OtherUNITED HEALTHCARE PROV. #