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NPI Code Detail

MEDICARE: DR. LEROY J KORB M.D.

MEDICARE: DR. LEROY J KORB 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
12085R0001XRadiation Oncology PhysicianMD044119LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10812860OTHERPABLUE SHIELD
211207738OTHERUNIVERA
3707311OTHERUPMC
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770572430
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEROY J KORB M.D.
Provider Business Mailing Address
First Line : 2 W CRESCENT PARK
Second Line :
City : WARREN
State : PA
Zip : 16365-2111
Country : US
Telephone Number : 814-723-3300
Fax Number : 814-723-8515
Provider Business Practice Location Address
First Line : 2 W CRESCENT PARK
Second Line :
City : WARREN
State : PA
Zip : 16365-2111
Country : US
Telephone Number : 814-723-3300
Fax Number : 814-723-8515
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 02/13/2013

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