# DR. JONATHAN T GHORMLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1982696464
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | R3946 | AR | Yes |

## Other

- **Enumeration date:** 08/19/2005
- **Last updated:** 12/31/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 115941001 | — | AR |
| 01 | — | 12591000000 | QUALCHOICE | AR |
| 05 | — | 130436716 | — | AR |
| 01 | — | 200017919 | RR MEDICARE | AR |
| 01 | — | 52911 | BCBS | AR |