Individual
MR. JOSHUA DERRELL CORLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1538
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20083400A
—
OK
01
—
245617201
MEDICARE
OK
01
—
PA1538
PA MEDICAL LICENSE
OK
Enumeration date
05/22/2006
Last updated
03/07/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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