MEDICARE: ROBERT KENDALL CORBETT JR. M.D.

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
1	207Q00000X	Family Medicine Physician	MD00034041	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00247612	OTHER	WA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0200955	OTHER	WA	LABOR AND INDUSTRIES

General Provider Information

NPI Number	:	1578565586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT KENDALL CORBETT JR. M.D.

Provider Business Mailing Address
First Line	:	9631 N NEVADA ST
Second Line	:	SUITE 304
City	:	SPOKANE
State	:	WA
Zip	:	99218-1193
Country	:	US
Telephone Number	:	509-466-1271
Fax Number	:	509-466-0969

Provider Business Practice Location Address
First Line	:	9631 N NEVADA ST
Second Line	:	SUITE 304
City	:	SPOKANE
State	:	WA
Zip	:	99218-1193
Country	:	US
Telephone Number	:	509-466-1271
Fax Number	:	509-466-0969

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	01/18/2008

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