Basic Information
| Provider Information | |||||||||
| NPI: | 1578560488 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CORKINS | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | P. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 143 LONGWATER DR | ||||||||
| Address2: | SOUTH SHORE MEDCAL CENTER, INC | ||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 143 LONGWATER DR | ||||||||
| Address2: | SOUTH SHORE MEDCAL CENTER, INC | ||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020611683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2005 | ||||||||
| LastUpdateDate: | 01/09/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 231814 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 157560488 | 01 | FALLON HEALTH CARE | OTHER | J42102 | 01 | MA | BLUE CROSS | OTHER | 496301 | 01 | TUFTS AND TUFTS MEDICARE PREFERRED | OTHER | 7319682 | 01 | AETNA | OTHER | 042297845 | 01 | TRICARE | OTHER | 042297845 | 01 | UNITED HEALTH CARE | OTHER | 8511963 | 01 | CIGNA | OTHER | 042297845 | 01 | PHCS/MULTI-PLAN | OTHER | 042297845 | 01 | GIC/UNICARE | OTHER | 1578560488 | 01 | GREAT WEST HEALTH CARE | OTHER | 042297845 | 01 | HCVM/FIRST HEALTH/COVENTRY | OTHER | 110077649A | 01 | MA | MASSHEALTH | OTHER | 1578560488 | 01 | NEIGHBORHOOD HEALTH PLAN | OTHER | AA95101 | 01 | MA | HARVARD PILGRIM | OTHER |