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NPI Code Detail

MEDICARE: DR. JAMES CORCORAN JR. MD, MPH

MEDICARE: DR. JAMES CORCORAN JR. MD, MPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianME 72239FL

General Provider Information

NPI Number : 1295125615
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES CORCORAN JR. MD, MPH
Provider Business Mailing Address
First Line : 532 RIVERSIDE AVE
Second Line : 20T
City : JACKSONVILLE
State : FL
Zip : 32202-4914
Country : US
Telephone Number : 904-791-8211
Fax Number :
Provider Business Practice Location Address
First Line : 532 RIVERSIDE AVE
Second Line : 20T
City : JACKSONVILLE
State : FL
Zip : 32202-4914
Country : US
Telephone Number : 904-791-8211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2015
Last Update Date : 01/24/2015

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