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Individual

JOHN CORKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-8166
Mailing address
3131 NEWMARK DR STE 220, MIAMISBURG, OH 45342-5400
(937) 436-4658
(937) 436-4984

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35.130075
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0224010
OH
Enumeration date
04/15/2014
Last updated
07/16/2019
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