Basic Information
| Provider Information | |||||||||
| NPI: | 1588089718 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GORMAN MEDICAL LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 62669 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809622669 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7192192400 | ||||||||
| FaxNumber: | 7192192409 | ||||||||
| Practice Location | |||||||||
| Address1: | 8540 SCARBOROUGH DR STE 370 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809207519 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193588270 | ||||||||
| FaxNumber: | 7193588299 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2014 | ||||||||
| LastUpdateDate: | 06/27/2022 | ||||||||
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| AuthorizedOfficialLastName: | GORMAN | ||||||||
| AuthorizedOfficialFirstName: | FRANCES | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | AUTHORIZED OFFICIAL / OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7193136028 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 10199 | CO | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.