Healthcare Provider Details

I. General information

NPI: 1689633182
Provider Name (Legal Business Name): WILLIAM DAVID CORBETT D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1961 FLOYD ST SUITE C
SARASOTA FL
34239-2931
US

IV. Provider business mailing address

2662 DICK WILSON DR
SARASOTA FL
34240-8723
US

V. Phone/Fax

Practice location:
  • Phone: 941-366-2627
  • Fax: 941-951-2356
Mailing address:
  • Phone: 941-342-6077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberP00000460
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: