Provider Demographics
NPI:1871585943
Name:CORBIN, SANDRA M (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:M
Last Name:CORBIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1490 N TURQUOISE DR
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-1383
Mailing Address - Country:US
Mailing Address - Phone:928-774-5074
Mailing Address - Fax:928-779-0884
Practice Address - Street 1:2500 S 8TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7132
Practice Address - Country:US
Practice Address - Phone:928-788-0785
Practice Address - Fax:928-783-0634
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2023-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ2289363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
970012393OtherRAIL ROAD MEDICARE
AZ518516Medicaid
AZ518516Medicaid
Z60757Medicare PIN