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Individual

JAMES T CORBETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1810 MESQUITE AVE STE B, LAKE HAVASU CITY, AZ 86403-5886
(928) 453-4600
Mailing address
36 KLONDIKE RD, REPUBLIC, WA 99166-9701
(509) 775-3153
(509) 775-8929

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5180
AZ
363A00000X
Physician Assistant
PA10003454
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8349417
WA
Enumeration date
02/15/2006
Last updated
03/17/2018
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