DR. RICHARD JAMES SERKOWSKI (NPI# 1174502090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174502090 |
Entity Type | Individual |
Full Name | DR. RICHARD JAMES SERKOWSKI |
Credential | DO, MPH, CPE |
Practice Address |
511 N Torch Blvd Bldg 300 Cannon Afb NM 88103-5109 |
Mailing Address |
1599 J St Bldg 109 Grand Forks Afb ND 58205-6332 |
Practice Telephone | 5757840287 |
Mailing Telephone | 7017475547 |
Enumeration Date | 2006-01-10 |
Last Update Date | 2018-03-27 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2083A0100X |
Preventive Medicine Specialization: Aerospace Medicine |
42767 | WI | Allopathic & Osteopathic Physicians |
N | 208D00000X | General Practice | 42767-021 | WI | Allopathic & Osteopathic Physicians |
Street Address |
511 N TORCH BLVD BLDG 300 |
City | CANNON AFB |
State | NM |
Zip Code | 88103-5109 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497067839 | Ray Leroy Schatz IIi | Military Health Care Provider | 511 N Torch Blvd, Cannon Afb, NM 88103-5109 | 2010-07-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346747151 | Isabella Wolak | Pharmacist | 224 D L Ingram Blvd, Cannon Afb, NM 88103 | 2018-04-09 |
1225480544 | Stacey Tatro | Dentist | 224 West D.l. Ingram Ave., Bldg 1408, Cannon Afb, NM 88103 | 2016-07-11 |
1871965673 | Chad Bryan Carter | Dentist | 224 W Dl Ingram Ave, Sgpd/dental Clinic, Cannon Air Force Base, NM 88103 | 2015-10-20 |
1740660836 | Terah Clifford | Dental Hygienist | 224 W Dl Ingram Blvd, Bldg 1408 Dental Clinic, Cannon Afb, NM 88103 | 2015-06-03 |
1528452208 | Taylor Bottari | Physician Assistant | 208 W Dl Ingram, Cannon Afb, NM 88103 | 2015-03-20 |
1588071328 | Gretchen Evelynn Szymanski | Nurse Practitioner | Cannon Afb, 224 W D.l. Ingram Blvd, Cannon Afb, NM 88103 | 2014-07-14 |
1396155206 | Jennifer Brynn Bendokas | Physician Assistant | 224 West Dl Ingram Avenue, Cannon Afb, NM 88103 | 2014-04-30 |
1366889487 | Jeremy Michael Strohmayer | General Practice | 511 Chindt Blvd Building 300, 27soss/osm, Cannon Afb, NM 88103 | 2013-05-30 |
1356622401 | Matthew John Nielsen | Dentist | 224 W D.l. Ingram, Bld. 1408, Cannon Afb, NM 88103 | 2011-09-02 |
1689965485 | Bryan Wade Sixkiller | Optometrist | 27th Somdg, 208 W. Casa Blanca Ave., Apo, AA 88103 | 2011-04-27 |
Find all providers in zip 88103 |
Taxonomy Code | 2083A0100X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Preventive Medicine |
Specialization | Aerospace Medicine |
Aerospace medicine focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles, together with the support personnel who assist operation of such vehicles. This population often works and lives in remote, isolated, extreme, or enclosed environments under conditions of physical and psychological stress. Practitioners strive for an optimal human-machine match in occupational settings rich with environmental hazards and engineering countermeasures. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558504068 | Logan D Jones | Preventive Medicine | 208 W Casablanca Ave Bldg 1400, Cannon Afb, NM 88103-5009 | 2009-04-14 |
1609914431 | David A Sarnow | Preventive Medicine | 208 W Casablanca Ave, 27 Somdg/flight Medicine, Bldg 1400, Cannon Afb, NM 88103-5014 | 2007-02-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639580574 | Joseph Abraham Parks | Preventive Medicine | Msc Physical Medicine & Rehabilitation, 1 University of New Mexico, Albuquerque, NM 87131 | 2014-05-14 |
1629043310 | Thomas D. Fadell Luna | Preventive Medicine | 2050 A Second St., Se, 377 Mdg/sgp, Kirtland Afb, NM 87117-5522 | 2006-02-17 |
1912465402 | Nicolas Ferry | Preventive Medicine | 1501 San Pedro Dr Se, Albuquerque, NM 87108-5180 | 2019-03-04 |
1548477284 | Clarence Edward Cotton Jr. | Preventive Medicine | 27 Medical Group, Clovis, NM 88103-5014 | 2007-05-16 |
1134192917 | Paul A. Young | Preventive Medicine | 2050a Second Street Se, Kirtland Afb, NM 87117-5522 | 2006-02-10 |
1114990280 | Mary Ann Terese Orzech | Preventive Medicine | 2050a 2nd St Se, Kirtland Afb, NM 87117-5522 | 2006-02-09 |
1326035676 | Walter Mark Matthews | Preventive Medicine | 208 W Casablanca Cannon Afb, Bldg 1400 27 Medical Group, Clovis, NM 88103-5014 | 2005-10-03 |
City | CANNON AFB |
Zip Code | 88103 |
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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.