Provider Demographics
NPI:1902853518
Name:SLEEP DISORDERS CENTER OF LONDON & CORBIN, PLLC
Entity Type:Organization
Organization Name:SLEEP DISORDERS CENTER OF LONDON & CORBIN, PLLC
Other - Org Name:SLEEP DISORDERS CENTER OF CORBIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-223-9990
Mailing Address - Street 1:3121 WALL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-9007
Mailing Address - Country:US
Mailing Address - Phone:859-223-9990
Mailing Address - Fax:859-219-9454
Practice Address - Street 1:95 BRYAN BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2775
Practice Address - Country:US
Practice Address - Phone:606-528-8144
Practice Address - Fax:606-528-2669
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLEEP DISORDERS CENTER OF LONDON & CORBIN, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-28
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY730086261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65942112Medicaid
KYP00138970OtherRAILROAD MEDICARE
KYP00138970OtherRAILROAD MEDICARE