Provider Demographics
NPI:1902049141
Name:IRWIN, CORINNA A (MD)
Entity Type:Individual
Prefix:
First Name:CORINNA
Middle Name:A
Last Name:IRWIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4208 SW LEE BLVD DEPT OF
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-8331
Mailing Address - Country:US
Mailing Address - Phone:580-536-7400
Mailing Address - Fax:580-536-7402
Practice Address - Street 1:4208 SW LEE BLVD DEPT OF
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-8331
Practice Address - Country:US
Practice Address - Phone:580-536-7400
Practice Address - Fax:580-536-7402
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2018-12-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK30757207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology