ZACKARY FORDHAM (NPI# 1265589089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265589089 |
Entity Type | Individual |
Full Name | ZACKARY FORDHAM |
Credential | MD |
Practice Address |
4500 13th St Gulfport MS 39502 |
Mailing Address |
4500 13th St Po Box 1810 Gulfport MS 39502 |
Practice Telephone | 6016723173 |
Mailing Telephone | 6016723173 |
Enumeration Date | 2007-01-04 |
Last Update Date | 2010-09-13 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207P00000X | Emergency Medicine | 21091 | MS | Allopathic & Osteopathic Physicians |
Y | 207P00000X | Emergency Medicine | 28369 | AL | Allopathic & Osteopathic Physicians |
Street Address |
4500 13TH ST |
City | GULFPORT |
State | MS |
Zip Code | 39502 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790777142 | Jack Q Causey II | Specialist | 4500 13th St, Gulfport, MS 39501-2515 | 2005-08-20 |
1255940110 | Brittany Threatt | Specialist/Technologist, Other | 4500 13th St, Gulfport, MS 39501-2515 | 2020-07-27 |
1881217792 | Dawn M Waters | Technician, Other | 4500 13th St, Gulfport, MS 39501-2569 | 2020-05-26 |
1356963953 | Jamie Rea Morris | Family Medicine | 4500 13th St, Gulfport, MS 39501-2515 | 2020-05-18 |
1497374490 | Alicia Lee Ellsberry | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2020-04-10 |
1578192035 | Lauren Martino | Pharmacist | 4500 13th St, Gulfport, MS 39501-2515 | 2020-04-06 |
1942840368 | Addie Holleman Holcomb | Registered Nurse | 4500 13th St, Gulfport, MS 39501-2515 | 2020-01-14 |
1477190114 | Shannon Vallee Canzoneri | Pharmacist | 4500 13th St, Gulfport, MS 39501-2515 | 2019-12-02 |
1629614003 | Kanieshia M Mitchell | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2569 | 2019-11-21 |
1346882339 | Molly H Weir | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2019-10-11 |
Find all providers in the same location |
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 |
---|---|---|---|---|
1083858674 | Charlton Paige Dennison | Emergency Medicine | 11446 Ashton Ln E, Gulfport, MS 39503-4428 | 2009-04-27 |
1487601050 | Kelly Michelle Nations | Emergency Medicine | 1510 Thornton Ave, Gulfport, MS 39501-2157 | 2006-05-28 |
1790731222 | Frederick B Gaupp | Emergency Medicine | 10556 Highway 49, Gulfport, MS 39503-4109 | 2006-05-26 |
1497735039 | Ronnie Ali | Emergency Medicine | 11564 Stanton Cir, Gulfport, MS 39503-6156 | 2006-01-19 |
1972587418 | Stanford Allen Owen | Emergency Medicine | 3300 15th St, Gulfport, MS 39501-3901 | 2005-11-29 |
1427580570 | Meagan Spear | Emergency Medicine | 4500 13th St, Gulfport, MS 39501-2569 | 2017-03-29 |
1689037178 | James Lawrence Rose II | Emergency Medicine | 4500 13th St, Gulfport, MS 39501-2515 | 2016-04-01 |
1881070183 | Keystone Medical Services of Gulfport, Inc. | Emergency Medicine | 15200 Community Rd, Gulfport, MS 39503-3085 | 2015-08-10 |
1932516945 | Mallory Blakeslee | Emergency Medicine | 4500 13th St, Gulfport, MS 39501-2569 | 2014-07-22 |
1962780379 | Memorial Hospital At Gulfport | Emergency Medicine | 4500 13th St, Emergency Department, Gulfport, MS 39501-2515 | 2011-08-02 |
Find all providers in GULFPORT |
Please comment or provide details below to improve the information on ZACKARY FORDHAM.
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.