Gorman, Douglas Edward

Gorman, Douglas Edward is an individual health care provider with primary practice located at 1920 Chadwick Dr Suite 108, Jackson MS 39204-3471. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery of the Hand, Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery is his primary health care specialty. Gorman, Douglas Edward can be contacted via phone (601) 373-3730.

Contact Information

Primary practice address
1920 Chadwick Dr Suite 108 Jackson MS 39204-3471
Phone: (601) 373-3730
Fax: (601) 372-7431
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery of the Hand 2082S0105X 08261 Mississippi
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 08261 Mississippi

Profile Details

NPI number 1699856419
LBN Legal business name Gorman, Douglas Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Jul 6th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699856419 NPPES
Mississippi Other 640650720 CORP TAX ID
Mississippi MEDICAID 00010048 CORP TAX ID

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