Jonathan Paul Gorham in Dyess Afb - Clinical
Jonathan Paul Gorham - NPI 1679754055
Jonathan Paul Gorham is a Clinical in Dyess Afb, Texas. Jonathan Paul Gorham practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jonathan Paul Gorham is 1679754055. The last update date is 2011-05-23.
Jonathan Paul Gorham's current location address is 697 Louisiana Dr., Dyess Afb, Texas. You can contact this provider via phone number 3256965380 and fax number 3526965579. The mailing address for Jonathan Paul Gorham is 697 Louisiana Dr., Dyess Afb, Texas. To know further, please read the information below!
Provider Profile Detail
Provider Name | Jonathan Paul Gorham |
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Address | 697 Louisiana Dr., Dyess Afb, Texas |
Phone Number | 3256965380 |
Fax Number | 3526965579 |
Sole Proprietor | Y |
Credentials | PSY.D. |
NPI Number Detail
NPI Number | 1679754055 |
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Provider Enumeration Date | 2007-11-14 |
Last Updated Date | 2011-05-23 |
Provider Mailing Address Detail
Address | 697 Louisiana Dr. |
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City | Dyess Afb |
State | Texas (TX) |
Post Code | 79607 |
Phone Number | 3256965380 |
Fax Number | 3526965579 |
Provider's Primary Taxonomy Detail
Speciality | Clinical |
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Taxonomy | 103Tc0700X |
Licence No | 019063-1 |
Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the Jonathan Paul Gorham's unique identification number?
The Jonathan Paul Gorham has been assigned the NPI (National Provider Identifier) Number 1679754055 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete address where Jonathan Paul Gorham is physically located?
The Jonathan Paul Gorham is situated at the following address: 697 Louisiana Dr., Dyess Afb, TX 79607.
What is Jonathan Paul Gorham's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Jonathan Paul Gorham is Clinical, and the corresponding taxonomy classification code for this specialized field is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1679754055 to Jonathan Paul Gorham?
The Jonathan Paul Gorham received its 1679754055 assignment from the Centers for Medicare & Medicaid Services on 2007-11-14.
As of what date was the information regarding Jonathan Paul Gorham, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Jonathan Paul Gorham, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2011-05-23.
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