Provider Demographics
NPI:1972613925
Name:CORBISHLEY, ANDREA MICHELE (MD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:MICHELE
Last Name:CORBISHLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MICHELE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112
Mailing Address - Country:US
Mailing Address - Phone:405-470-7100
Mailing Address - Fax:405-470-7111
Practice Address - Street 1:5720 W MEMORIAL RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-2010
Practice Address - Country:US
Practice Address - Phone:405-470-7100
Practice Address - Fax:405-470-7111
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25549207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine