Provider Demographics
NPI:1801826953
Name:KORBY, GORDON J (DO,, DC)
Entity Type:Individual
Prefix:DR
First Name:GORDON
Middle Name:J
Last Name:KORBY
Suffix:
Gender:M
Credentials:DO,, DC
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Mailing Address - Street 1:1021 COUNTRY CLUB RD
Mailing Address - Street 2:STE B
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2484
Mailing Address - Country:US
Mailing Address - Phone:614-762-7312
Mailing Address - Fax:888-551-2775
Practice Address - Street 1:1021 COUNTRY CLUB RD
Practice Address - Street 2:STE B
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2484
Practice Address - Country:US
Practice Address - Phone:614-762-7312
Practice Address - Fax:888-551-2775
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2014-09-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34-0068142081P0004X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2067445Medicaid
OHP01331308Medicare PIN
OH2067445Medicaid
OH0849457Medicare PIN