MEDICARE: DR. SHAUN C CORBIN MD

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
1	207YS0012X	Sleep Medicine (Otolaryngology) Physician	30290	TN
2	207YX0602X	Otolaryngic Allergy Physician	30290	TN
3	207Y00000X	Otolaryngology Physician	30290	TN

General Provider Information

NPI Number	:	1669421814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAUN C CORBIN MD

Provider Business Mailing Address
First Line	:	927 N JAMES CAMPBELL BLVD
Second Line	:	STE 101
City	:	COLUMBIA
State	:	TN
Zip	:	38401-6436
Country	:	US
Telephone Number	:	931-380-9166
Fax Number	:	931-388-4105

Provider Business Practice Location Address
First Line	:	927 N JAMES CAMPBELL BLVD
Second Line	:	STE 101
City	:	COLUMBIA
State	:	TN
Zip	:	38401-6436
Country	:	US
Telephone Number	:	931-380-9166
Fax Number	:	931-388-4105

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	10/19/2021

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Directions to “ DR. SHAUN C CORBIN MD” Practice Location

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