Brent R Korn, D.O.
Individual provider Active NPI Internal Medicine Physician · Scottsdale, AZ
NPI 1811078025 · NPPES record last updated Jan 13, 2009
Key facts
- NPI
- 1811078025
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 4328 (AZ)
- Practice address
- 8759 E Bell Rd
Scottsdale, AZ 85260-1322 - Phone
- (602) 569-4144
- Fax
- (602) 569-4244
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4328 | AZ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Life Medical, LLC | Current |
Accepting new patients | |
| Mount Carmel Health | Family Medicine | Past | Accepting new patients |
| Gita Jafari-Raske, M.D., PLLC | Internal Medicine | Past |
Accepting new patients |
| 4C Medical Group PLC | Family Medicine | Past | Accepting new patients |
| Desert Canyon Internal Medicine PLLC | Internal Medicine | Past | Accepting new patients |
Locations
2915 E Baseline Rd
Ste 105
Gilbert, AZ 85234
Phone (480) 354-6700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4328 | AZ | Yes |
Addresses
Primary practice location
8759 E Bell Rd
Scottsdale, AZ 85260-1322
Mailing address
8759 E Bell Rd
Scottsdale, AZ 85260-1322
Phone (602) 569-4144
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 092074 | Medicaid | AZ |
Other providers in Scottsdale, AZ
- Kor Smile PLLC
- Mary Ellen Koran
- Kore Chiropractic, PLLC
- Noel William Korf
- Melissa Korkes
- Ronald Lee Korn
- Marlies W. Korsten
- Mia Elizabeth Korum
- Ruth Aida Kosak
- Katelyn Terese Koschmeder
All providers in Scottsdale, AZ · Internal Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.