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General NPI Number Information
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NPI Number | 1487796637
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Entity Type | Organization
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Legal Business Name | CHRISTA CORN, MD, PLLC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2040 W BETHANY HOME RD SUITE 1
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City | PHOENIX
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State | AZ
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Zip | 85015-2445
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Country | US
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Telephone | 602-246-8666
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Fax | 602-246-6082
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Provider Business Mailing Address
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Address Line | 2040 W BETHANY HOME RD SUITE 1
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City | PHOENIX
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State | AZ
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Zip | 85015-2445
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Country | US
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Telephone | 602-246-8666
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Fax | 602-246-6082
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTA CORN
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Credential |
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Telephone | 602-246-8666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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