Douglas Edward Gorman Jr., M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

08261 Issued in MS

Practice address

1920 Chadwick Dr
Suite 108
Jackson, MS 39204-3471

Phone

(601) 373-3730

Fax

(601) 372-7431

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: gormanpsc@degm-ms.direct.office.nextgen.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1699856419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 CHADWICK DR",
            "address_2": "SUITE 108",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043471",
            "telephone_number": "601-373-3730",
            "fax_number": "601-372-7431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 CHADWICK DR",
            "address_2": "SUITE 108",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043471",
            "telephone_number": "601-373-3730",
            "fax_number": "601-372-7431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "DOUGLAS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "MS",
            "license": "08261",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MS",
            "license": "08261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORP TAX ID",
            "identifier": "640650720",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00010048",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rita L Gordon, APRN
• Frances Moran Gordy, D.M.D.
• Mary Gordy, NP
• Michelle Borzik Goreth, CPNP-AC
• Srinivasa Sanjay Surya Gorla, M.D
• Stephanie Gorrell, PT
• Natalia Maria Gorrondona
• Nathan William Goss, NP
• Itedrianna Goston
• Angelica Gowdy, PCMHT

• Plastic and Reconstructive Surgery Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Plastic and Reconstructive Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.