IAN JAMES MUKISA (NPI# 1821632985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821632985 |
| Entity Type | Individual |
| Full Name | IAN JAMES MUKISA |
| Credential | PA |
| Practice Address |
Dwight David Eisenhower Army Medical Center 300 East Hospital Road Fort Gordon GA 30909-5650 |
| Mailing Address |
300 East Hospital Road Fort Gordon GA 30909-5650 |
| Practice Telephone | 6315681009 |
| Practice Fax Number | 7067871745 |
| Mailing Fax Number | 7067871745 |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2019-11-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | GA | Student, Health Care |
| Street Address |
DWIGHT DAVID EISENHOWER ARMY MEDICAL CENTER 300 EAST HOSPITAL ROAD |
| City | FORT GORDON |
| State | GA |
| Zip Code | 30909-5650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811923725 | Steven Tiernan | Emergency Medicine | Dwight David Eisenhower Army Medical Center, Fort Gordon, GA 30905 | 2006-06-23 |
| 1972021343 | Nancy Hausterman | Student in an Organized Health Care Education/Training Program | Dwight David Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2017-09-06 |
| 1295165678 | David Davis | Registered Nurse | Dwight David Eisenhower Army Medical Center, Office 4a-28, Fort Gordon, GA 30905 | 2013-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513888 | Lauran Simpson | Behavior Technician | 1237 Augusta West Parkway, Augusta, GA 30909 | 2020-09-16 |
| 1487273884 | Still Perspectives Counseling LLC | Counselor | 1265 Inerstate Prwy, Suite B, Augusta, GA 30909 | 2020-04-15 |
| 1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
| 1003452319 | Danny Robinson | Counselor | 2609 Commons Boulevard, Augusta, GA 30909 | 2019-11-21 |
| 1407498637 | Candice M Cruse | Social Worker | 2609 Commons Blvd, Augusta, GA 30909 | 2019-10-09 |
| 1902363385 | Mary D Jodon | Pharmacist | 3338 Wrightsboro Rd., Augusta, GA 30909 | 2019-02-21 |
| 1447790514 | Burn Critical Care Associates, LLC | Internal Medicine | 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 | 2017-03-08 |
| 1124561766 | Sasha Latara Mccraw | Counselor | 7303 Palomino Court, Augusta, GA 30909 | 2016-11-30 |
| 1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
| 1811358955 | Theodora Mcleskey | Nurse Practitioner | 1215 George C. Wilson Drive, Augusta, GA 30909 | 2016-03-17 |
| Find all providers in zip 30909 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230387 | William Edward Bane | Student in an Organized Health Care Education/Training Program | 320 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2020-06-23 |
| 1972125763 | Mark Edward Gartner | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency, Dwight D. Eisenhower Army, Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2020-05-14 |
| 1184284598 | Nicholas James Carlin | Student in an Organized Health Care Education/Training Program | Medicine, Dwight David Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2019-06-18 |
| 1700446341 | Nicholas John Carter | Student in an Organized Health Care Education/Training Program | Eisenhower Army Medical Center Gme, 300 E. Hospital Rd, Fort Gordon, GA 30905-5650 | 2019-06-17 |
| 1306405931 | Kevin Ryan Patrick | Student in an Organized Health Care Education/Training Program | Interserive Physician Assitant Program, 300 East Hospital Road, Fort Gordon, GA 30905-5670 | 2019-06-07 |
| 1366009805 | Briana Francina Krieger | Student in an Organized Health Care Education/Training Program | 300 East Hospical Road, Fort Gordon, GA 30905-5650 | 2019-05-21 |
| 1639735822 | Jon Thomas Heald | Student in an Organized Health Care Education/Training Program | Internal Medicine, Eisenhower Army Medical Center, Fort Gordon, GA 30905-5650 | 2019-05-14 |
| 1487218269 | David Keith Mecham | Student in an Organized Health Care Education/Training Program | Internal Medicine, Dwight David Eisenhower Army Medical, 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2019-04-26 |
| 1740765544 | Jesse Goldblatt | Student in an Organized Health Care Education/Training Program | Clinical Psychology Internship Program, Ddeamc, 300 East Hospital Road, Fort Gordon, GA 30905-5650 | 2018-09-27 |
| 1902390065 | Rafael Jacob Kaplan | Student in an Organized Health Care Education/Training Program | Ty, Dwight David Eisenhower Army Medical Center, 300 East Hospital Rd, Fort Gordon, GA 30905-5650 | 2018-06-21 |
| Find all providers in FORT GORDON | ||||
| City | FORT GORDON |
| Zip Code | 30909 |
Please comment or provide details below to improve the information on IAN JAMES MUKISA.
| 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.