Provider Demographics
NPI:1952542029
Name:KORBYL, ROBERT EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EDWARD
Last Name:KORBYL
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 1:4419-50TH AVE
Mailing Address - Street 2:#105
Mailing Address - City:RED DEER
Mailing Address - State:AB
Mailing Address - Zip Code:T4N3Z5
Mailing Address - Country:CA
Mailing Address - Phone:403-343-1315
Mailing Address - Fax:403-343-1099
Practice Address - Street 1:4419-50TH AVE
Practice Address - Street 2:#105
Practice Address - City:RED DEER
Practice Address - State:AB
Practice Address - Zip Code:T4N3Z5
Practice Address - Country:CA
Practice Address - Phone:403-340-4156
Practice Address - Fax:403-343-1099
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA209704207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery