Provider Demographics
NPI:1871604272
Name:CORBY REHABILITATION SERVICES, INC.
Entity type:Organization
Organization Name:CORBY REHABILITATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:CORBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-442-7476
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:SEELYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47878-0399
Mailing Address - Country:US
Mailing Address - Phone:812-442-7476
Mailing Address - Fax:812-442-7545
Practice Address - Street 1:4018 WESTOAK VALLEY DR
Practice Address - Street 2:
Practice Address - City:LANESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47136-9475
Practice Address - Country:US
Practice Address - Phone:812-442-7476
Practice Address - Fax:812-442-7545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01045450A208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000360341OtherBLUE CROSS BLUE SHIELD
INDD1727OtherHEALTH NET FEDERAL SERVIC
INDD1727OtherTRICARE
IN200508870AOtherMEDICAID
IN607877400OtherBLACK LUNG PROGRAM
INDD1727OtherPALMETTO TRICARE
INDD1727Medicare PIN
IN224570Medicare PIN