Basic Information
| Provider Information | |||||||||
| NPI: | 1366547994 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRITT | ||||||||
| FirstName: | CORNELIUS | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 94220 4TH ST | ||||||||
| Address2: | |||||||||
| City: | GOLD BEACH | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974447756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412473000 | ||||||||
| FaxNumber: | 5412473104 | ||||||||
| Practice Location | |||||||||
| Address1: | 94220 4TH ST | ||||||||
| Address2: | |||||||||
| City: | GOLD BEACH | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974447756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412473910 | ||||||||
| FaxNumber: | 5412473109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2006 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | MD179516 | OR | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 119263 | 01 | OR | CURRY HEALTH DISTRICT MEDICAID | OTHER | 1487696985 | 01 | OR | CURRY HEALTH DISTRICT NPI | OTHER | 930937095 | 01 | OR | CURRY HEALTH DISTRICT TAX I.D. | OTHER | R0000ZGBDG | 01 | OR | CURRY HEALTH DISTRICT MEDICARE | OTHER | 500717826 | 05 | OR | MEDICAID |