Blake Cooper Corcoran M.D.

NPI 1235490038 - Family Medicine - 207Q00000X

NPI Details
NPI 1235490038
Gender Male
Enumeration Date 06/07/2012
Last Updated 08/18/2015
Entity Type Individual
Active Over 5 years ago
Practice Location
30 NORTH 1900 EAST 1C412
SALT LAKE CITY UT, 84132-2115, US
Phone (801) 581-2401
Fax (801) 585-2507
Business Location
127 S. 500 E.
SALT LAKE CITY UT, 84102-1971, US
Phone (801) 587-6336
Fax (573) 884-4122
Taxonomy Code 207Q00000X
License State Missouri
License Number 2012015733
Remove 1235490038 NPI Number

According to our database, Blake Cooper Corcoran M.D. NPI is 1235490038, taxonomy code is 207Q00000X and license number is 2012015733, license state is located at Missouri. Blake Cooper Corcoran M.D. physically located at University Of Utah Hospitals & Clinics, Salt Lake City UT, 84132-2115. NPI Number Blake Cooper Corcoran M.D. has the Individual type.

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1235490038 NPI number is provided on an as is basis without warranty of any kind. 1235490038 is maintained by the National Plan & Provider Enumeration System. The contents of Blake Cooper Corcoran M.D. are for informational purposes only.