Basic Information
| Provider Information | |||||||||
| NPI: | 1134223738 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CORN | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1340 HAL GREER BLVD | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 257013804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043996727 | ||||||||
| FaxNumber: | 3043996726 | ||||||||
| Practice Location | |||||||||
| Address1: | 1340 HAL GREER BLVD | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 257013804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043996727 | ||||||||
| FaxNumber: | 3043996726 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2006 | ||||||||
| LastUpdateDate: | 08/24/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 20462 | WV | N | Allopathic & Osteopathic Physicians | Hospitalist | 207Q00000X | 20462 | WV | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2000262000 | 05 | WV | MEDICAID | 7100038050 | 05 | KY | MEDICAID | 2262037 | 05 | OH | MEDICAID | 001722780 | 01 | WV | BCBS | OTHER | 550783705 | 01 | WV | COMMERICAL | OTHER | 7418280 | 01 | WV | AETNA | OTHER | 7386121 | 01 | WV | MEDICARE PTAN - CHHI | OTHER |