Corcoran, J Russell

Corcoran, J Russell is an individual health care provider with primary practice located at 70 Kenyon Ave Suite 215, Wakefield RI 02879-4239. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Geriatric Medicine is his primary health care specialty. Corcoran, J Russell can be contacted via phone (401) 783-0084.

Contact Information

Primary practice address
70 Kenyon Ave Suite 215 Wakefield RI 02879-4239
Phone: (401) 783-0084
Fax: (401) 782-0005
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X MD06582 Rhode Island
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X MD06582 Rhode Island

Profile Details

NPI number 1689661241
LBN Legal business name Corcoran, J Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2005
Last updated Aug 7th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689661241 NPPES
Rhode Island MEDICAID 9002371
Rhode Island Other 007056627

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