Individual
MARK R CORKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
51 N DUNLAP ST STE 400, MEMPHIS, TN 38105-4625
(901) 287-5928
Mailing address
51 N DUNLAP ST STE 400, MEMPHIS, TN 38105-4625
(901) 287-5928
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
01051266
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000321537
ANTHEM-DEAC-350593390
—
05
—
200238280
—
IN
05
—
2655112
—
OH
01
—
350593390-042
TRICARE-DEAC-350593390
—
05
—
4840830
—
MI
05
—
64000185
—
KY
Enumeration date
08/21/2006
Last updated
08/12/2016
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