Provider Demographics
NPI:1982736062
Name:WENDY KINSEY CORNING, M.D., LLC
Entity Type:Organization
Organization Name:WENDY KINSEY CORNING, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:KINSEY
Authorized Official - Last Name:CORNING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-330-5250
Mailing Address - Street 1:383 S PARK RIDGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-8574
Mailing Address - Country:US
Mailing Address - Phone:812-330-5250
Mailing Address - Fax:812-330-5240
Practice Address - Street 1:383 S PARK RIDGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-8574
Practice Address - Country:US
Practice Address - Phone:812-330-5250
Practice Address - Fax:812-330-5240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01044201207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ING12647Medicare UPIN