Individual
DR. CAROLINE M CORPUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
310 THOMPSON AVE, EL DORADO, AR 71730-4569
(870) 862-4216
(870) 862-9011
Mailing address
321 MOCKINGBIRD LN, EL DORADO, AR 71730-2837
(870) 875-8838
(870) 875-8838
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
E-7213
AR
207W00000X
Ophthalmology Physician
Primary
E-7213
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194054001
—
AR
01
—
P01082504
RAILROAD MEDICARE
AR
Enumeration date
07/13/2009
Last updated
12/11/2012
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