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General NPI Number Information
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NPI Number | 1083734941
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Entity Type | Organization
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Legal Business Name | GEORGE B CORN PLLC
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Dates
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Enumeration Date | 04/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2410 JEFFERSON AVE
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City | PT PLEASANT
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State | WV
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Zip | 25550-1528
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Country | US
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Telephone | 304-675-7100
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Fax | 304-675-7102
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Provider Business Mailing Address
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Address Line | 2410 JEFFERSON AVE
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City | PT PLEASANT
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State | WV
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Zip | 25550-1528
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Country | US
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Telephone | 304-675-7100
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Fax | 304-675-7102
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Authorized Official
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Title or Position | MD
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Name | GEORGE B CORN
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Credential | MD
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Telephone | 304-675-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20462
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License Number State | WV
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