MR. MARK GOSNELL JR. (NPI# 1265954952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265954952 |
| Entity Type | Individual |
| Full Name | MR. MARK GOSNELL JR. |
| Credential | IDMT |
| Practice Address |
7050 Air Depot Blvd Tinker Afb OK 73145-8716 |
| Practice Telephone | 4055826055 |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2017-07-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003949348 | Mark Steven Gosnell | Internal Medicine | 515 Fairmount Ave Ste 500, Towson, MD 21286-5466 | 2007-03-14 |
| Street Address |
7050 AIR DEPOT BLVD |
| City | TINKER AFB |
| State | OK |
| Zip Code | 73145-8716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902893084 | Michelle Marie Wueste | Pediatrics | 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 | 2005-10-04 |
| 1114486701 | James Neal Dillard IIi | Physician Assistant | 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 | 2019-03-14 |
| 1407313125 | Cindy Yie | Physician Assistant | 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 | 2019-02-28 |
| 1720501299 | William Moore | Student in an Organized Health Care Education/Training Program | 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 | 2017-07-17 |
| 1245780170 | Mary Phillips | Social Worker | 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 | 2016-10-04 |
| 1528418175 | David Rodriguez | Family Medicine | 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 | 2016-06-14 |
| 1497120760 | Thaddeus Dwayne Mitcham | Physician Assistant | 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 | 2015-12-11 |
| 1659755064 | Benjamin Winston | Dentist | 7050 Air Depot Blvd, Sgdd, Tinker Afb, OK 73145-8716 | 2015-07-15 |
| 1063895068 | Andrea Theye | Psychologist | 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 | 2015-07-08 |
| 1598148850 | Adrianna Harrell | Social Worker | 7050 Air Depot Blvd, Tinker Afb, OK 73145 | 2015-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922630946 | The Janz Corporation | Durable Medical Equipment & Medical Supplies | Tinker Afb Exchange, 3360 N. Avenue Bldg. 685, Tinker Afb, OK 73145 | 2020-02-07 |
| 1578863437 | Stephanie Brushett | Audiologist | 8941 Entrance Road A, Bldg 3334, Rm 125, Tinker Afb, OK 73145 | 2010-10-26 |
| 1972530053 | Mark Robert Bacon | Physician Assistant | 72nd Medical Group, 5700 Arnold St, Tinker Afb, OK 73145 | 2006-06-26 |
| 1417945346 | Heather Renee' Ranger Kobel | Psychologist | 590 Mitchell Blvd, Tinker Afb, OK 73145 | 2005-10-13 |
| 1003332404 | Davis Brigman | Psychologist | 7050 Air Depot Blvd Bldg 1094, Tinker Afb, OK 73145 | 2017-08-17 |
| 1801321393 | Carolyne Bangurah | Registered Nurse | 7050 Air Depot Blvd Bldg 1094, Tinker Afb, OK 73145 | 2017-04-21 |
| 1558748491 | Caitlin Clare Stevens | General Practice | 7050 Air Depot Blvd Bldg 1094, Tinker Afb, OK 73145 | 2015-04-29 |
| 1033498571 | Sarah Katherine Turbush | Dentist | 72d Medical Group, Tinker Afb, OK 73145 | 2011-08-16 |
| 1508000282 | Axelandra Tamar Sang | Military Health Care Provider | 5700 Arnold St, Bldg 5801, Tinker Afb, OK 73145 | 2009-04-27 |
| 1790936466 | William David Hinojosa | Surgery | 7050 Air Depot Blvd Bldg 1094, Tinker Afb, OK 73145 | 2008-09-30 |
| Find all providers in zip 73145 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023364676 | Cheila Taina Rodriguez | Military Health Care Provider | 7156 Nabors Dr Apt C, Tinker Afb, OK 73145-4584 | 2012-08-01 |
| 1811318751 | Bridget Williams | Military Health Care Provider | 7050 Air Depot Blvd, Bldg 1094, Tinker Afb, OK 73145-8716 | 2013-12-19 |
| 1568720282 | Christopher Grayson Hampton | Military Health Care Provider | 7050 Air Depot Blvd, Bldg 1094, Tinker Afb, OK 73145-8716 | 2012-05-01 |
| 1831407006 | James Allan Pickren | Military Health Care Provider | 5700 Arnold St, Tinker Afb, OK 73145-8105 | 2010-09-21 |
| 1497084180 | Nancy M. Chavez-mozingo | Military Health Care Provider | 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 | 2009-12-09 |
| 1255575577 | Stuart Scott Smith | Military Health Care Provider | 5700 Arnold St, Tinker Afb, OK 73145-8105 | 2009-04-30 |
| 1508000282 | Axelandra Tamar Sang | Military Health Care Provider | 5700 Arnold St, Bldg 5801, Tinker Afb, OK 73145 | 2009-04-27 |
| 1811131980 | Jackie Glen Whitten Jr. | Military Health Care Provider | 5700 Arnold St, Bldg 5801, Tinker Afb, OK 73145-8105 | 2009-04-21 |
| 1083857189 | Jeanne Ann Lewis | Military Health Care Provider | 5700 Arnold St, Bldg 5801, Tinker Afb, OK 73145-8105 | 2009-04-20 |
| 1417190513 | Yamily Cruz Soto | Military Health Care Provider | 5700 Arnold St Bldg 5801, Tinker Afb, OK 73145-8105 | 2009-04-20 |
| Find all providers in TINKER AFB | ||||
| City | TINKER AFB |
| Zip Code | 73145 |
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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.