Provider Demographics
NPI:1811152184
Name:CORBIN DIGESTIVE AND LIVER DISEASE CENTER, PLLC
Entity type:Organization
Organization Name:CORBIN DIGESTIVE AND LIVER DISEASE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:O'KUMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-258-7470
Mailing Address - Street 1:1321 CUMBERLAND FALLS HWY STE 3
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-2720
Mailing Address - Country:US
Mailing Address - Phone:606-258-7470
Mailing Address - Fax:
Practice Address - Street 1:1321 CUMBERLAND FALLS HWY
Practice Address - Street 2:STE 3
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2720
Practice Address - Country:US
Practice Address - Phone:606-258-7470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty