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General NPI Number Information
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NPI Number | 1932209335
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Entity Type | Individual
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Provider Name | TIMOTHY WILEY CORBETT SR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 07/27/2011
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Provider Practice Location Address
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Address Line | 324 COMMERCE RD SUITE A
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City | FARMVILLE
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State | VA
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Zip | 23901-2794
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Country | US
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Telephone | 434-392-9366
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Fax | 434-392-9348
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Provider Business Mailing Address
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Address Line | 324 COMMERCE RD SUITE A
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City | FARMVILLE
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State | VA
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Zip | 23901-2794
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Country | US
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Telephone | 434-392-9366
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Fax | 434-392-9348
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101057605
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License Number State | VA
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