Healthcare Provider Details

I. General information

NPI: 1336067032
Provider Name (Legal Business Name): MEGAN MCCORKLE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 CLAIRMONT RD # UNITSB&C
DECATUR GA
30033-5484
US

IV. Provider business mailing address

3111 FORTUNE AVE
TEXARKANA TX
75503-1552
US

V. Phone/Fax

Practice location:
  • Phone: 470-480-1910
  • Fax:
Mailing address:
  • Phone: 903-293-6522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT018397
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: