Gorman, Jim F

Gorman, Jim F is an individual health care provider with primary practice located at 530 East Riley Drive , Avondale AZ 85323. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Gorman, Jim F can be contacted via phone (623) 832-7407.

Contact Information

Primary practice address
530 East Riley Drive Avondale AZ 85323
Phone: (623) 832-7407
Fax: (623) 932-1884
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X Arizona

Profile Details

NPI number 1255483079
LBN Legal business name Gorman, Jim F
Credentials MC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2007
Last updated Jul 26th, 2007 - about 19 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 1255483079 NPPES
Arizona Other 594722 AHCCCS MEMBERS
Arizona Other 588668 AHCCCS MEMBERS

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