DR. GORDON THOMAS MARKHAM (NPI# 1043447113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043447113 |
| Entity Type | Individual |
| Full Name | DR. GORDON THOMAS MARKHAM |
| Credential | M.D. |
| Practice Address |
554 Keily Street Jacksonville FL 32212 |
| Practice Telephone | 7579537550 |
| Practice Fax Number | 7579537560 |
| Mailing Telephone | 7579537550 |
| Mailing Fax Number | 7579537560 |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2019-01-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | M-2072 | GU | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | MTL-2017-074 | GU | Allopathic & Osteopathic Physicians |
| Y | 207P00000X | Emergency Medicine | 0101248004 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
554 KEILY STREET |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326019373 | Brian G Norwood | Pediatrics | 554 Keily Street, Jacksonville, FL 32212 | 2006-01-29 |
| 1811461726 | Yocelin Hernandez Rojero | Occupational Therapist | 554 Keily Street, Jacksonville Fl 32212, Jacksonville, FL 32212 | 2019-01-14 |
| 1609381235 | Miranda Shilelagh Schmidt | Physician Assistant | 554 Keily Street, Jacksonville, FL 32212 | 2017-12-05 |
| 1144733627 | Tylisha Elyse Deshields | Social Worker | 554 Keily Street, Jacksonville, FL 32212 | 2017-11-07 |
| 1326557976 | David Michael Tatera | Psychologist | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-27 |
| 1104335348 | Kuang-hui Lee | General Practice | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-20 |
| 1548788177 | Sophia Renee Beal | Speech-Language Pathologist | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-04 |
| 1164949418 | George S Bennitt | Dentist | 554 Keily Street, Jacksonville, FL 32212-4047 | 2017-08-28 |
| 1124545389 | David Phillips | Student in an Organized Health Care Education/Training Program | 554 Keily Street, Centralized Credential and Privileging Directorate, Jacksonville, FL 32212-2466 | 2017-08-28 |
| 1902323652 | Erich Chen | Student in an Organized Health Care Education/Training Program | 554 Keily Street, Jacksonville, FL 32212 | 2017-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1518484427 | Amy Kathryn Lee | Student in an Organized Health Care Education/Training Program | Bumed, Centralized Credential & Privileging Directorate, 554 Keily Street, Jacksonville, FL 32212 | 2017-08-23 |
| 1659827970 | Noah Fixelle | Dentist | Bureau of Med and Surg Ccpd, 554 Keily Street, Jacksonville, VA 32212 | 2016-08-28 |
| 1972953339 | Colin Kenneth Kelly | General Practice | Bureau of Medicine & Surgery Detachment, Nas Jacksonville, Building 554, Jacksonville, FL 32212 | 2016-06-16 |
| 1912382359 | Caitlyn Brooke Hoysock | Dentist | 554 Keiley Street, Bureau of Medicine and Surgery - Credentials, Jacksonville, FL 32212 | 2015-07-28 |
| 1285017418 | John Alexander Ruch | Dentist | 554 Keily Street Bureau of Med and Surg Ccpd, Jacksonville, FL 32212 | 2015-07-07 |
| 1407238561 | Amanda Mona Lau | Student in an Organized Health Care Education/Training Program | 554 Kelly Street, Attn Centralized Credentialing, Bureau of Medicine and Surgery, Jacksonville, FL 32212 | 2015-06-25 |
| 1063894715 | Heather Dehaan | Family Medicine | 554 Kelly Street Bureau of Medicine and Surgery, Attention: Centralized Credentialing & Privileging Dire, Jacksonville, FL 32212 | 2015-06-18 |
| 1912389677 | Catherine Garcia | Student in an Organized Health Care Education/Training Program | 554 Kelly St, Credentialing & Privileging Directorate, Bureau of Medicine & Surgery, Attention: Centralized, Jacksonville, FL 32212 | 2015-06-18 |
| 1255712675 | James Robert Benson | Dentist | 734 Keily Street, Bumed, Jacksonville, FL 32212 | 2015-06-11 |
| Find all providers in zip 32212 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427690353 | Emergency Physicians Inc | Emergency Medicine | 9868 Family Place, Jacksonville, FL 32222 | 2019-10-11 |
| 1104301159 | Emergency Physicians Inc | Emergency Medicine | 14534 Old St Augustine Rd, Suite 3110, Jacksonville, FL 32258 | 2018-09-26 |
| 1922525229 | Dwic of Tampa Bay, Inc | Emergency Medicine | 11985 Atlantic Boulevard, Jacksonville, FL 32225-2919 | 2017-08-28 |
| 1063945541 | Hassan Mohammad Aboudan | Emergency Medicine | 8455 Stables Rd, Jacksonville, FL 32256-7265 | 2017-04-11 |
| 1639626476 | Emergency Physicians Inc | Emergency Medicine | 11250 Baptist Health Drive, Suite 713, Jacksonville, FL 32218 | 2016-09-09 |
| 1497107957 | Frank Rodriguez | Emergency Medicine | 7615 Hunters Grove Rd, Jacksonville, FL 32256-7210 | 2016-07-08 |
| 1649631391 | Emergency Physicians Inc | Emergency Medicine | 4085 Town Center Pkwy, Jacksonville, FL 32246-8580 | 2016-03-09 |
| 1619387099 | John Michael Kiel | Emergency Medicine | Department of Emergency Medicine, 125 Floor Clinical Ce, 655 West 8th Street, C506, Jacksonville, FL 32209-3220 | 2014-05-06 |
| 1225455306 | James Esser Barr | Emergency Medicine | 653 W 8th St # L15, Jacksonville, FL 32209-6511 | 2014-03-26 |
| 1992122170 | Nadia Bakor | Emergency Medicine | 6477 103rd St, Jacksonville, FL 32210-7129 | 2014-03-25 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32212 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.