Individual
VIRGINIA CORCORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 S UTICA AVE STE A, TULSA, OK 74104
(918) 748-7557
(918) 748-7514
Mailing address
1725 E 19TH ST STE 500, TULSA, OK 74104-5422
(918) 403-7089
(918) 744-2946
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2859
OK
363A00000X
Physician Assistant
5629
OK
Other
Enumeration date
12/14/2017
Last updated
06/27/2019
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