Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | DR0052142 | CO |
Y | 207VX0201X | Gynecologic Oncologist | DR.0052142 | CO |
NPI | 1255566964 |
---|---|
Provider Name | Bradley Robert Corr |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2009 |
Last Update Date | 21/11/2018 |