Individual
DR. CARLA CORK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
5555 N TACOMA AVE, SUITE, 12, INDIANAPOLIS, IN 46220-3512
(317) 501-0210
(317) 236-6054
Mailing address
PO BOX 7140, FISHERS, IN 46038-7140
(317) 501-0210
(317) 236-6054
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02003708A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201178190
—
IN
Enumeration date
07/27/2007
Last updated
01/23/2017
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