Basic Information
| Provider Information | |||||||||
| NPI: | 1538523659 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THOMAS R. CORLEY, M.D., LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 738 | ||||||||
| Address2: | |||||||||
| City: | GADSDEN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 359020738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2564395000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 801 GOODYEAR AVE | ||||||||
| Address2: | |||||||||
| City: | GADSDEN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 359031133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2564395000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2016 | ||||||||
| LastUpdateDate: | 06/14/2016 | ||||||||
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| AuthorizedOfficialLastName: | CORLEY | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 2564395000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | MD.9848 | AL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.