Provider Demographics
NPI:1952484958
Name:CORRIGAN PODIATRY GROUP
Entity Type:Organization
Organization Name:CORRIGAN PODIATRY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CORRIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:440-871-3400
Mailing Address - Street 1:28687 CENTER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-3810
Mailing Address - Country:US
Mailing Address - Phone:440-871-3400
Mailing Address - Fax:440-871-3433
Practice Address - Street 1:28687 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-3810
Practice Address - Country:US
Practice Address - Phone:440-871-3400
Practice Address - Fax:440-871-3433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003355C213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH200149025001OtherMEDICAL MUTUAL
OH200149025027OtherCARESOURCE
OH2430382Medicaid
OH000000479599OtherANTHEM BLUE CROSS BLUE SHIELD
OHMEDICARE IS PENDINGOtherBRAND NEW PRACTICE
OH7697230OtherCIGNA
OHDF7284OtherMEDICARE RRB
OHMEDICARE IS PENDINGOtherBRAND NEW PRACTICE
OH200149025027OtherCARESOURCE