Individual
DR. TIMOTHY CORGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1400 UNIVERSITY DR, SUITE 101, MARINETTE, WI 54143-5105
(715) 732-4181
Mailing address
1400 UNIVERSITY DR, SUITE 101, MARINETTE, WI 54143-5105
(715) 732-4181
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2655-035
WI
152W00000X
Optometrist
4901003841
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38597500
—
WI
Enumeration date
05/25/2006
Last updated
03/07/2023
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