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NPI Code Detail

MEDICARE: DR. ALLEN DOUGLAS MCCORKLE DDS

MEDICARE:  DR. ALLEN DOUGLAS MCCORKLE  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry0401004900VA

General Provider Information

NPI Number : 1114920865
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALLEN DOUGLAS MCCORKLE DDS
Provider Business Mailing Address
First Line : 1829 PLAZA DR
Second Line :
City : WINCHESTER
State : VA
Zip : 22601-6365
Country : US
Telephone Number : 540-667-4880
Fax Number : 540-667-4881
Provider Business Practice Location Address
First Line : 1829 PLAZA DR
Second Line :
City : WINCHESTER
State : VA
Zip : 22601-6365
Country : US
Telephone Number : 540-667-4880
Fax Number : 540-667-4881
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 09/17/2019

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Directions to “ DR. ALLEN DOUGLAS MCCORKLE DDS” Practice Location

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