Provider Demographics
NPI:1255592697
Name:VEATCH, CORINA JOY (MD)
Entity type:Individual
Prefix:
First Name:CORINA
Middle Name:JOY
Last Name:VEATCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W UTOPIA RD
Mailing Address - Street 2:STE. 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-4171
Mailing Address - Country:US
Mailing Address - Phone:602-214-6148
Mailing Address - Fax:602-214-6149
Practice Address - Street 1:20330 N CAVE CREEK RD
Practice Address - Street 2:STE. 160
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-4465
Practice Address - Country:US
Practice Address - Phone:602-730-8443
Practice Address - Fax:602-730-8444
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ70866207R00000X
AZ46346208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ731589Medicaid