Gorham, Marian Jeanne

Gorham, Marian Jeanne is an individual health care provider with primary practice located at 1 Medical Village Dr Independent Anesthesiologists Psc, Edgewood KY 41017-3403. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Gorham, Marian Jeanne can be contacted via phone (859) 341-7246.

Contact Information

Primary practice address
1 Medical Village Dr Independent Anesthesiologists Psc Edgewood KY 41017-3403
Phone: (859) 341-7246
Fax: (859) 341-7867
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 27219 Kentucky

Profile Details

NPI number 1285615401
LBN Legal business name Gorham, Marian Jeanne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2005
Last updated Feb 20th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285615401 NPPES
Kentucky MEDICAID 64272198
Kentucky Other 000000032751
Kentucky MEDICAID 0958861
Kentucky Other 11308605

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