Provider Demographics
NPI:1669421814
Name:CORBIN, SHAUN C (MD)
Entity type:Individual
Prefix:DR
First Name:SHAUN
Middle Name:C
Last Name:CORBIN
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 1:927 N JAMES CAMPBELL BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-6436
Mailing Address - Country:US
Mailing Address - Phone:931-380-9166
Mailing Address - Fax:931-388-4105
Practice Address - Street 1:927 N JAMES CAMPBELL BLVD
Practice Address - Street 2:STE 101
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-6436
Practice Address - Country:US
Practice Address - Phone:931-380-9166
Practice Address - Fax:931-388-4105
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30290207YS0012X, 207YX0602X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNG82235Medicare UPIN
TN3827193Medicare ID - Type Unspecified