Provider Demographics
NPI:1295759793
Name:CORBIN, DAVID KIPLYN (DC, CCSP)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KIPLYN
Last Name:CORBIN
Suffix:
Gender:M
Credentials:DC, CCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 82808
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70884-2808
Mailing Address - Country:US
Mailing Address - Phone:225-766-3031
Mailing Address - Fax:225-767-0045
Practice Address - Street 1:7731 PERKINS RD
Practice Address - Street 2:SUITE 155
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1078
Practice Address - Country:US
Practice Address - Phone:225-766-3031
Practice Address - Fax:225-767-0045
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA588111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA59425Medicare ID - Type UnspecifiedPROVIDER NUMBER