Provider Demographics
NPI:1982728465
Name:CORKER, ARTHUR A JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:A
Last Name:CORKER
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46219 BALDWIN DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-5220
Mailing Address - Country:US
Mailing Address - Phone:586-764-4965
Mailing Address - Fax:
Practice Address - Street 1:10950 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48213-1330
Practice Address - Country:US
Practice Address - Phone:313-521-1850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23846183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist