Jason Dumrongkulraksa (NPI# 1205115573, PAC ID# 3870748064) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1205115573 |
| PAC ID by PECOS | 3870748064 |
| Professional Enrollment ID | I20130218000514 |
| Full Name | Jason Dumrongkulraksa |
| Organization Legal Name | AUSTRALIAN LUNGFISH SURGICAL SPECIALISTS LLC |
| Address |
1000 Mar Walt Dr Fort Walton Beach FL 32547-6708 |
| Phone Number | 3178054640 |
| Gender | M |
| Graduation Year | 2011 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4183940877 |
| Number of Group Practice Members | 15 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100242 | GULF COAST REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 3178054640 | AUSTRALIAN LUNGFISH SURGICAL SPECIALISTS LLC |
| 449 W 23 St, Panama City, FL 32405-4507 | 8507698341 | CIRQUE OF TOWERS INPATIENT SERVICES LLC |
| Organization Legal Name | AUSTRALIAN LUNGFISH SURGICAL SPECIALISTS LLC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jamison E Gaddy | Physician Assistant | Australian Lungfish Surgical Specialists LLC | 1703 Lewis Turner Blvd, Fort Walton Beach, FL 32547-1221 |
| Megan Kayla Renner | Physician Assistant | Australian Lungfish Surgical Specialists LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Andrew Mikulaschek | General Surgery | Australian Lungfish Surgical Specialists LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Patrick T Mcgraw | General Surgery | Australian Lungfish Surgical Specialists LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Derek Robinson | Physician Assistant | Australian Lungfish Surgical Specialists LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Mary P Colvin | General Surgery | Australian Lungfish Surgical Specialists LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Rachel Houck | Nurse Practitioner | Australian Lungfish Surgical Specialists LLC | 1703 Lewis Turner Blvd, Fort Walton Beach, FL 32547-1221 |
| Kevin Beall | Physician Assistant | Australian Lungfish Surgical Specialists LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Robert Lowry | Nurse Practitioner | Australian Lungfish Surgical Specialists LLC | 1703 Lewis Turner Blvd, Fort Walton Beach, FL 32547-1221 |
| Cathy V Ho | General Surgery | Australian Lungfish Surgical Specialists LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Street Address |
1000 MAR WALT DR |
| City | FORT WALTON BEACH |
| State | FL |
| Zip | 32547-6708 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gary David Wright | Emergency Medicine | Thomasville Emergency Physicians LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Pamela S Buckallew | Nurse Practitioner | Fl-i Medical Services LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Timothy A Rak | Emergency Medicine | Thomasville Emergency Physicians LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Sean E Thompson | Certified Registered Nurse Anesthetist (crna) | Anesthesia Physician Solutions of North Florida LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Cathleen C Hoffman | Nurse Practitioner | Fl-i Medical Services LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Anne Marie Crow | Nurse Practitioner | Fl-i Medical Services LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Yvonne M Browning | Certified Registered Nurse Anesthetist (crna) | Anesthesia Physician Solutions of North Florida LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Troy Saline | Emergency Medicine | Thomasville Emergency Physicians LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| John E Fortenberry | Emergency Medicine | Thomasville Emergency Physicians LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Megan Kayla Renner | Physician Assistant | Australian Lungfish Surgical Specialists LLC | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Morris E Gales Iii | General Surgery | Florida Post Acute Care Clinicians LLC | 1 L B J Sr Dr, Fort Walton Beach, FL 32547-1163 |
| John D Sites | Family Medicine | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Teresa Marie Skojac | Family Medicine | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Peter Kerr Senechal | Family Medicine | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Chris George Pappas | Family Medicine | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Christopher P Paulson | Family Medicine | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Susan T Ott | Nurse Practitioner | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Brandy Marie Lackey | Nurse Practitioner | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Grant Eugene Zachary | Family Medicine | Magnolia Medical Clinic P.a. | 319 Green Acres Rd, Suite 101, Fort Walton Beach, FL 32547-1170 |
| Jamison E Gaddy | Physician Assistant | Australian Lungfish Surgical Specialists LLC | 1703 Lewis Turner Blvd, Fort Walton Beach, FL 32547-1221 |
| Find all physicians in zip 32547 | |||
| City | FORT WALTON BEACH |
| Zip Code | 32547 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | FORT WALTON BEACH + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Jason Dumrongkulraksa.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.