Provider Demographics
NPI:1386753440
Name:CORCORAN, HELEN LUCILLE (MD)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:LUCILLE
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 BURNET AVE
Mailing Address - Street 2:3 SOUTH
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3019
Mailing Address - Country:US
Mailing Address - Phone:513-585-5501
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2364
Practice Address - Country:US
Practice Address - Phone:513-584-2146
Practice Address - Fax:513-584-0431
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350469402085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0664053Medicaid
OH4305970OtherAETNA
OHP00226525OtherRAILROAD MEDICARE
OH000000573577OtherANTHEM
IN100355100Medicaid
KY64788847Medicaid
OHP00226525OtherRAILROAD MEDICARE
OH0664053Medicaid