MEDICARE: COREY EUGENE CLAIBORNE DPT

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1811701980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COREY EUGENE CLAIBORNE DPT

Provider Business Mailing Address
First Line	:	1354 GATEWOOD DR
Second Line	:
City	:	AUBURN
State	:	AL
Zip	:	36830-7702
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5409 SUMMERVILLE RD STE 3
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-7437
Country	:	US
Telephone Number	:	334-947-1327
Fax Number	:

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

Provider Enumeration Date	:	02/06/2025
Last Update Date	:	02/06/2025

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