Corcoran, Justin

Corcoran, Justin is an individual health care provider with primary practice located at 9200 W Wisconsin Ave , Milwaukee WI 53226-3522. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Medical Toxicology, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Corcoran, Justin can be contacted via phone (414) 805-6450.

Contact Information

Primary practice address
9200 W Wisconsin Ave Milwaukee WI 53226-3522
Phone: (414) 805-6450
Fax: (414) 805-6464
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Medical Toxicology 207PT0002X 73181 Wisconsin
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 73181 Wisconsin

Profile Details

NPI number 1174903645
LBN Legal business name Corcoran, Justin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2015
Last updated Nov 4th, 2022 - about 2 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 1174903645 NPPES
Wisconsin MEDICAID 1174903645

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