Dr Jonathan Paul Gorham, PSYD is a
Psychologist - Clinical based in Dyess Afb, Texas. Dr Jonathan Paul Gorham is licensed to practice in New York (license number 019063-1) and his current practice location is
697 Louisiana Dr., Dyess Afb, Texas. He can be reached at his office (for appointments etc.) via phone at
(325) 696-5380.
NPI number for Dr Jonathan Paul Gorham is 1679754055 and his current mailing address is 697 Louisiana Dr., Dyess Afb, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1679754055.
Healthcare Provider's Profile
Full Name | Dr Jonathan Paul Gorham |
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Gender | Male |
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Speciality | Psychologist - Clinical |
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Location | 697 Louisiana Dr., Dyess Afb, Texas |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1679754055
- Provider Enumeration Date: 11/14/2007
- Last Update Date: 05/23/2011
Medical Identifiers
Medical identifiers for Dr Jonathan Paul Gorham such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1679754055 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC0700X | Psychologist - Clinical | 019063-1 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jonathan Paul Gorham is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Jonathan Paul Gorham, PSYD 697 Louisiana Dr., Dyess Afb, TX 79607 Ph: (325) 696-5380 | Dr Jonathan Paul Gorham, PSYD 697 Louisiana Dr., Dyess Afb, TX 79607 Ph: (325) 696-5380 |
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