Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | A26572 | CA |
NPI | 1023067238 |
---|---|
Provider Name | Anthony G L Corkill |
First Address | Redding, CA 96001-0228 |
Second Address | Redding, CA 96001-0228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 05/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023067238 | (05) | CA |