Provider Demographics
NPI:1508846536
Name:CORNER, CHRISTOPHER JENKINS (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JENKINS
Last Name:CORNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 SHERIDAN DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3956
Mailing Address - Country:US
Mailing Address - Phone:740-653-9186
Mailing Address - Fax:740-653-9214
Practice Address - Street 1:1334 SHERIDAN DR
Practice Address - Street 2:SUITE 2
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3956
Practice Address - Country:US
Practice Address - Phone:740-653-9186
Practice Address - Fax:740-653-9214
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0614462084P0800X, 2084P0804X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2017552Medicaid
OH2017552Medicaid
OHE76569Medicare UPIN
OH9340921Medicare ID - Type UnspecifiedGROUP ID NUMBER