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General NPI Number Information
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NPI Number | 1013192848
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Entity Type | Organization
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Legal Business Name | DOUGLAS C. MCCORKLE M.D., P.A.
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Dates
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Enumeration Date | 12/28/2007
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Last Update Date | 12/28/2007
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Provider Practice Location Address
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Address Line | 10 CROSSROADS DR SUITE 100
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5458
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Country | US
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Telephone | 410-363-7172
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Fax | 410-363-7188
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Provider Business Mailing Address
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Address Line | 10 CROSSROADS DR SUITE 100
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5458
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Country | US
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Telephone | 410-363-7172
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Fax | 410-363-7188
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS CARLTON MCCORKLE
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Credential | M.D.
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Telephone | 410-363-7172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | D0033742
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License Number State | MD
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