| Doctor Name: | BLAKE COOPER CORCORAN |
| NPI Number: | 1235490038 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 2012015733 |
| Business Practice Address: | University Of Utah Hospitals & Clinics 30 North 1900 East 1c412 Salt Lake City, UT - 841322115 |
| Business Phone Number: | 8015812401 |
| Business Fax Number: | 8015852507 |
| Mailing Address: | 127 S. 500 E., Suite 600 SALT LAKE CITY |
| State: | UT |
| Postal Code: | 841021971 |
| Phone Number: | 8015876336 |
| Fax Number: | 8017158228 |
| NPI Enumeration Date: | 06/07/2012 |
| NPI Last Update Date: | 08/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207Q00000X |
| License Number: | 2012015733 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |