DWIGHT D EISENHOWER MEDICAL CENTER (NPI# 1225465511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225465511 |
| Entity Type | Organization |
| Organization Name | DWIGHT D EISENHOWER MEDICAL CENTER |
| Practice Address |
300 W Hospital Rd Fort Gordon GA 30905-5741 |
| Practice Telephone | 7067875624 |
| Mailing Telephone | 7067875624 |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2013-10-11 |
| Authorized Official Name | MS. LESLIE WALKER ROBERSON (MAJ/DOT) |
| Authorized Official Telephone | 7067875624 |
| Authorized Official Credential | MAED, CLIN PSY I |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 286500000X | Military Hospital | Hospitals |
| Street Address |
300 W HOSPITAL RD |
| City | FORT GORDON |
| State | GA |
| Zip Code | 30905-5741 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922007467 | John Keenan Wilson | Internal Medicine | 300 W Hospital Rd, Building 300, Fort Gordon, GA 30905-5741 | 2005-07-18 |
| 1629687751 | Benjamin Lee Tigges | Nurse Anesthetist, Certified Registered | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2020-07-24 |
| 1104441179 | Gia-thien H Nguyen | Student in an Organized Health Care Education/Training Program | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2020-06-15 |
| 1184249765 | Roman Avila | Student in an Organized Health Care Education/Training Program | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2020-06-10 |
| 1417572116 | Francesco Anthony Biolzi | Student in an Organized Health Care Education/Training Program | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2020-06-09 |
| 1114568268 | Ryan Sever | Psychologist | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2019-09-30 |
| 1801446497 | Seth Randall | Nurse Practitioner | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2019-09-16 |
| 1275188179 | Jason Celestino | Nurse Anesthetist, Certified Registered | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2019-08-07 |
| 1467011668 | Angelina Kathleen Trush | Student in an Organized Health Care Education/Training Program | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2019-06-11 |
| 1790271989 | Joshua Orszag | Nurse Anesthetist, Certified Registered | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2018-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417508995 | Priscilla Denise Brown | Prosthetic/Orthotic Supplier | 38200 3rd Ave, Fort Gordon, GA 30905 | 2019-09-25 |
| 1740754308 | Patricia Lynn Blevins | Nurse Practitioner | 300 E Hospital Dr, Augusta, GA 30905 | 2019-01-17 |
| 1861971335 | Isabella Anderson | Dentist | Usa Dental Activity, Hospital Dental Clinic, Bldg 38801 Academic, Ste B&c, Ft Gordon, GA 30905 | 2018-08-07 |
| 1972097426 | Cortney Wolfley | Student in an Organized Health Care Education/Training Program | Orthopaedics Ddeamc, 300 East Hospital Road, Fort Gordon, GA 30905 | 2018-06-19 |
| 1003337536 | David Jonathon Sabovich | Dentist | 38801 Academic Dr Ste B&cactivity, Suite B & C, Ft Gordon, GA 30905 | 2017-07-06 |
| 1437689411 | Marcos Aranda | Student in an Organized Health Care Education/Training Program | General Surgery, Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2017-06-13 |
| 1659809846 | Brian Kevin Burke | Student in an Organized Health Care Education/Training Program | 300 East Hosptial Road, Fort Gordon, GA 30905 | 2017-06-01 |
| 1902334469 | Jacqueline Renee Mulhall | Student in an Organized Health Care Education/Training Program | Ddeamc, 300 E Hospital Rd, General Surgery, Fort Gordon, GA 30905 | 2017-05-30 |
| 1750837456 | Amanda R Bailey | Internal Medicine | 300 E. Hospital Dr., Fort Gordon, GA 30905 | 2016-09-01 |
| 1689120016 | Thomas S Moffitt | Internal Medicine | Im, Dwight D Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2016-08-26 |
| Find all providers in zip 30905 | ||||
| Taxonomy Code | 286500000X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| A health care facility operated by the Department of Defense. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629357934 | United States Army | Military Hospital | 300 W Hospital Rd Rm 7a-46, Fort Gordon, GA 30905-5741 | 2011-08-04 |
| 1306399043 | Trevor Wesley Tobin | Military Hospital | 300 E Hospital Rd, Fort Gordon, GA 30905 | 2016-07-29 |
| 1497002240 | Tania I. Didas | Military Hospital | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2012-08-11 |
| 1033425897 | Dwight D. Eisenhower Hospital, Fort Gordon | Military Hospital | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2010-08-30 |
| 1740446905 | Ddeamc | Military Hospital | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2008-08-06 |
| 1225184088 | Eisenhower Army Medical Center | Military Hospital | 300 W Hospital Road, Eisenhower Army Medical Center Credentials, Fort Gordon, GA 30905-5650 | 2007-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982154241 | Department of Veteran Affairs | Military Hospital | 1122 Providence Way, Lawrenceville, GA 30046-3316 | 2016-10-11 |
| 1417307190 | Sanghyub Lee | Military Hospital | 411 E 9th St # 74, Fort Stewart, GA 31314-5036 | 2016-06-14 |
| 1770956252 | Clara Mccomb | Military Hospital | 6600 Van Aalst Blvd., Fort Benning, GA 31905 | 2015-11-05 |
| 1790113348 | Veronica Garrett | Military Hospital | 804 Rosemont Pkwy, Roswell, GA 30076-4934 | 2013-10-17 |
| 1780942664 | Martin Army Community Hospital | Military Hospital | 8830 Watkins Ave, Fort Benning, GA 31905-5529 | 2012-04-27 |
| 1093947780 | Army | Military Hospital | 202 Vineyard Way, Apt. 601, Evans, GA 30809 | 2009-08-14 |
| 1497953012 | Va Medical Center | Military Hospital | 1401 Post Oak Dr Apt F, Clarkston, GA 30021-3145 | 2007-07-05 |
| 1609806504 | Va Medical Center | Military Hospital | 940 Capella Creek Way, Grayson, GA 30017-1578 | 2006-07-04 |
| 1508312711 | Martin Army Community Hospital | Military Hospital | Martin Army Community Hospital, 6600 Van Aalst Blvd, Bldg 9250, Fort Benning, GA 31905 | 2016-08-28 |
| 1508312869 | Debbie Speed-simmons | Military Hospital | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2016-08-28 |
| Find all providers with the same taxonomy | ||||
| City | FORT GORDON |
| Zip Code | 30905 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.