Provider Demographics
NPI:1063422350
Name:QUINN, CORINNE F (MD)
Entity type:Individual
Prefix:DR
First Name:CORINNE
Middle Name:F
Last Name:QUINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CORINNE
Other - Middle Name:QUINN
Other - Last Name:RODGERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:600 PROFESSIONAL DR
Mailing Address - Street 2:130
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-7638
Mailing Address - Country:US
Mailing Address - Phone:678-225-5678
Mailing Address - Fax:678-225-5676
Practice Address - Street 1:600 PROFESSIONAL DR
Practice Address - Street 2:130
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-7638
Practice Address - Country:US
Practice Address - Phone:678-225-5678
Practice Address - Fax:678-225-5676
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA20798207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000229358CMedicaid
GAD40918Medicare UPIN