Individual
DR. JACQUELINE E CORCORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1400 SOUTH DOBSON ROAD, ATTN: BMG HOSPITALIST TEAM/ AMANDA GUMP, MESA, AZ 85202
(480) 412-6788
(480) 412-6848
Mailing address
1400 SOUTH DOBSON ROAD, ATTN: BMG HOSPITALIST TEAM/ AMANDA GUMP, MESA, AZ 85202
(480) 412-6788
(480) 412-6848
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
006360
AZ
207R00000X
Internal Medicine Physician
5101015935
MI
208M00000X
Hospitalist Physician
Primary
006360
AZ
208M00000X
Hospitalist Physician
5101015935
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114632103
—
MI
01
—
1659401834
NPI
MI
01
—
5821617
BCBS
MI
Enumeration date
03/06/2007
Last updated
02/19/2021
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