Provider Demographics
NPI:1902030166
Name:STRICKLAND, CORINNE DENISE (MD)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:DENISE
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 E HAVASU RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-2518
Mailing Address - Country:US
Mailing Address - Phone:520-991-7281
Mailing Address - Fax:
Practice Address - Street 1:4350 E HAVASU RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-2518
Practice Address - Country:US
Practice Address - Phone:520-991-7281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ511082085R0202X, 2085U0001X, 2085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ005472OtherGROUP MEDICAID ID
AZP01625211OtherMEDICARE RAILROAD FOR PROVIDER
AZ1841261989OtherGROUP NPI
AZ082803Medicaid
AZCS7943OtherGROUP MEDICARE RAILROAD ID
AZZWCBBMOtherGROUP MEDICARE ID
AZZ183584Medicare PIN