Individual
CAROLYN RUTH CORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4050 W MEMORIAL RD FL 3, OKLAHOMA CITY, OK 73120-8382
(405) 608-3800
(405) 608-3831
Mailing address
7800 NW 85TH TER, OKLAHOMA CITY, OK 73132-3385
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
11990
OK
207UN0901X
Nuclear Cardiology Physician
Primary
11990
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060045004
RAILROAD MEDICARE
OK
05
—
100827670B
—
OK
Enumeration date
09/01/2005
Last updated
06/06/2022
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