Provider Demographics
NPI:1801885397
Name:CORRIGAN, TOM ADOLPH (DPM)
Entity type:Individual
Prefix:DR
First Name:TOM
Middle Name:ADOLPH
Last Name:CORRIGAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15810 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3711
Mailing Address - Country:US
Mailing Address - Phone:216-529-1800
Mailing Address - Fax:216-529-3201
Practice Address - Street 1:15810 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-3711
Practice Address - Country:US
Practice Address - Phone:216-529-1800
Practice Address - Fax:216-529-3201
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-3355-C213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2430382Medicaid
OH00000478187OtherANTHEM BLUE CROSS BLUE SHIELD
OHP00388602OtherMEDICARE RRB
OH200149025OtherTRICARE
OH200149025027OtherCARESOURCE
OH200149025001OtherMEDICAL MUTUAL
OH735898OtherBUCKEYE
OH7611806OtherAETNA
OH7697230OtherCIGNA
OHBC8451368Medicare UPIN
OH7611806OtherAETNA
OH2430382Medicaid