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General NPI Number Information
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NPI Number | 1366409500
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Entity Type | Individual
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Provider Name | TODD DOUGLAS CORN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | 101 W 8TH AVE
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City | SPOKANE
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State | WA
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Zip | 99204-2307
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Country | US
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Telephone | 509-474-3260
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Fax |
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Provider Business Mailing Address
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Address Line | 101 W 8TH AVE
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City | SPOKANE
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State | WA
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Zip | 99204-2364
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD60247710
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 24499
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License Number State | OK
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