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NPI Code Detail

MEDICARE: CORY HEAL MD

MEDICARE: CORY HEAL MD
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
1207R00000XInternal Medicine PhysicianMT214018PA
2208D00000XGeneral Practice Physician58630AZ
32085R0001XRadiation Oncology Physician58630AZ
4390200000XStudent in an Organized Health Care Education/Training Program
52085R0001XRadiation Oncology PhysicianR76666AZ

General Provider Information

NPI Number : 1366970337
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORY HEAL MD
Provider Business Mailing Address
First Line : PO BOX 749495
Second Line :
City : ATLANTA
State : GA
Zip : 30374-9495
Country : US
Telephone Number : 855-963-2100
Fax Number : 813-321-1296
Provider Business Practice Location Address
First Line : 1281 E COTTONWOOD LN
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85122-2949
Country : US
Telephone Number : 520-863-9800
Fax Number : 520-863-1510
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2017
Last Update Date : 03/12/2026

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