Provider Demographics
NPI:1972012920
Name:CORCORAN, KATHLEEN MARIE (DVM)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:MARIE
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:DVM
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Mailing Address - Street 1:14501 TRISKETT RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-2269
Mailing Address - Country:US
Mailing Address - Phone:216-987-5450
Mailing Address - Fax:216-987-5066
Practice Address - Street 1:14501 TRISKETT RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-2269
Practice Address - Country:US
Practice Address - Phone:216-987-5450
Practice Address - Fax:216-987-5066
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH52822083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine