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NPI Code Detail

MEDICARE: ANITA F CORNETT MD

MEDICARE: ANITA F CORNETT 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
12083A0300XAddiction Medicine (Preventive Medicine) Physician27472KY
2207R00000XInternal Medicine Physician27472KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P01490899OTHERKYRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770553463
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANITA F CORNETT MD
Provider Business Mailing Address
First Line : 509 MEMORIAL DR STE 2
Second Line :
City : MANCHESTER
State : KY
Zip : 40962-6196
Country : US
Telephone Number : 606-598-5104
Fax Number : 606-598-0983
Provider Business Practice Location Address
First Line : 210 MARIE LANGDON DR
Second Line :
City : MANCHESTER
State : KY
Zip : 40962-6388
Country : US
Telephone Number : 606-598-5104
Fax Number : 606-598-0983
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 03/07/2023

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Directions to “ ANITA F CORNETT MD” Practice Location

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