Provider Demographics
NPI:1336908854
Name:CORSO, CHRIS JR (DO)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:CORSO
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 W 14TH ST # HA-6065
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2369
Mailing Address - Country:US
Mailing Address - Phone:317-274-0267
Mailing Address - Fax:
Practice Address - Street 1:350 W 14TH ST # HA6065
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2369
Practice Address - Country:US
Practice Address - Phone:317-274-0267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2025-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program