Corcoran, Jacqueline E

Corcoran, Jacqueline E is an individual health care provider with primary practice located at 1400 South Dobson Road Attn: Bmg Hospitalist Team/ Amanda Gump, Mesa AZ 85202. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Corcoran, Jacqueline E can be contacted via phone (480) 412-6788.

Contact Information

Primary practice address
1400 South Dobson Road Attn: Bmg Hospitalist Team/ Amanda Gump Mesa AZ 85202
Fax: (480) 412-6848
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 5101015935 Michigan
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 006360 Arizona
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 5101015935 Michigan
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 006360 Arizona

Profile Details

NPI number 1659401834
LBN Legal business name Corcoran, Jacqueline E
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2007
Last updated Feb 19th, 2021 - about 3 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 1659401834 NPPES
Michigan Other 1659401834 NPI
Michigan Other 5821617 NPI
Michigan MEDICAID 114632103 NPI

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