Individual
DR. JACK B. GORMAN
Active
Individual
DR. JACK B. GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
SC001284L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0023085000
KEYSTONE BLUE SHEILD
PA
01
—
048077
HIGHMARK BLUE SHEILD
PA
05
—
0505452
—
PA
01
—
31851A
KEYSTONE MERCY
PA
01
—
T23784
HEALTH PARTNERS
PA
Enumeration date
06/28/2006
Last updated
05/29/2008
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