Individual
DR. PATRICK D GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2985 CORTEZ AVE, IDAHO FALLS, ID 83404-2985
(208) 523-3373
(208) 523-8746
Mailing address
2985 CORTEZ AVE, IDAHO FALLS, ID 83404-2985
(208) 523-3373
(208) 523-8746
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
F86110
MD
207RC0000X
Cardiovascular Disease Physician
Primary
M-8388
ID
207RC0000X
Cardiovascular Disease Physician
M8388
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010136417
BS OF IDAHO
—
01
—
060067151
RAILROAD MEDICARE
—
01
—
1103740
CIGNA
—
01
—
118682500
EDS CONSULTEC, INC.
WY
05
—
118682500
—
WY
01
—
46763
BC OF IDAHO
—
05
—
806232000
—
ID
Enumeration date
07/27/2005
Last updated
11/17/2015
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