Gorman, Mark Richard

Gorman, Mark Richard is an sole proprietor health care provider with primary practice located at 10214 N Tatum Blvd Ste B300 , Phoenix AZ 85028-4233. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Gorman, Mark Richard can be contacted via phone (602) 954-0777.

Contact Information

Primary practice address
10214 N Tatum Blvd Ste B300 Phoenix AZ 85028-4233
Phone: (602) 954-0777
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 0069 Arizona

Profile Details

NPI number 1780680165
LBN Legal business name Gorman, Mark Richard
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 22nd, 2005
Last updated Aug 8th, 2022 - about 2 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 1780680165 NPPES
Arizona Other 0065330 BCBSAZ PROVIDER #
Arizona Other 700444 BCBSAZ PROVIDER #

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