Provider Demographics
NPI:1306272489
Name:MIDKIFF, CORY L (DPT)
Entity type:Individual
Prefix:
First Name:CORY
Middle Name:L
Last Name:MIDKIFF
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2190 NEW HOLT RD STE D
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-8929
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2190 NEW HOLT RD STE D
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-8929
Practice Address - Country:US
Practice Address - Phone:270-557-2121
Practice Address - Fax:270-557-2123
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist