MR. MARK GOSNELL JR.


Address: 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716
Phone: 4055826055

MR. MARK GOSNELL JR. (NPI# 1265954952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265954952
Entity Type Individual
Full Name MR. MARK GOSNELL JR.
Credential IDMT
Practice Address 7050 Air Depot Blvd
Tinker Afb
OK 73145-8716
Practice Telephone 4055826055
Enumeration Date 2017-07-13
Last Update Date 2017-07-13
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1003X Military Health Care Provider
Specialization: Independent Duty Medical Technicians
Other Service Providers

Other Providers MARK GOSNELL

NPI Name Taxonomy Address Enumeration
1003949348 Mark Steven Gosnell Internal Medicine 515 Fairmount Ave Ste 500, Towson, MD 21286-5466 2007-03-14

Office Location

Street Address 7050 AIR DEPOT BLVD
City TINKER AFB
State OK
Zip Code 73145-8716

Providers in the same location

NPI Name Taxonomy Address Enumeration
1902893084 Michelle Marie Wueste Pediatrics 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2005-10-04
1114486701 James Neal Dillard IIi Physician Assistant 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2019-03-14
1407313125 Cindy Yie Physician Assistant 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2019-02-28
1720501299 William Moore Student in an Organized Health Care Education/Training Program 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2017-07-17
1245780170 Mary Phillips Social Worker 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2016-10-04
1528418175 David Rodriguez Family Medicine 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2016-06-14
1497120760 Thaddeus Dwayne Mitcham Physician Assistant 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2015-12-11
1659755064 Benjamin Winston Dentist 7050 Air Depot Blvd, Sgdd, Tinker Afb, OK 73145-8716 2015-07-15
1063895068 Andrea Theye Psychologist 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2015-07-08
1598148850 Adrianna Harrell Social Worker 7050 Air Depot Blvd, Tinker Afb, OK 73145 2015-07-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1922630946 The Janz Corporation Durable Medical Equipment & Medical Supplies Tinker Afb Exchange, 3360 N. Avenue Bldg. 685, Tinker Afb, OK 73145 2020-02-07
1578863437 Stephanie Brushett Audiologist 8941 Entrance Road A, Bldg 3334, Rm 125, Tinker Afb, OK 73145 2010-10-26
1972530053 Mark Robert Bacon Physician Assistant 72nd Medical Group, 5700 Arnold St, Tinker Afb, OK 73145 2006-06-26
1417945346 Heather Renee' Ranger Kobel Psychologist 590 Mitchell Blvd, Tinker Afb, OK 73145 2005-10-13
1003332404 Davis Brigman Psychologist 7050 Air Depot Blvd Bldg 1094, Tinker Afb, OK 73145 2017-08-17
1801321393 Carolyne Bangurah Registered Nurse 7050 Air Depot Blvd Bldg 1094, Tinker Afb, OK 73145 2017-04-21
1558748491 Caitlin Clare Stevens General Practice 7050 Air Depot Blvd Bldg 1094, Tinker Afb, OK 73145 2015-04-29
1033498571 Sarah Katherine Turbush Dentist 72d Medical Group, Tinker Afb, OK 73145 2011-08-16
1508000282 Axelandra Tamar Sang Military Health Care Provider 5700 Arnold St, Bldg 5801, Tinker Afb, OK 73145 2009-04-27
1790936466 William David Hinojosa Surgery 7050 Air Depot Blvd Bldg 1094, Tinker Afb, OK 73145 2008-09-30
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Taxonomy Information

Taxonomy Code 1710I1003X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Medical Technicians

Taxonomy Definition

An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
Notes: Source: Air Force Surgeon General Office [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1023364676 Cheila Taina Rodriguez Military Health Care Provider 7156 Nabors Dr Apt C, Tinker Afb, OK 73145-4584 2012-08-01
1811318751 Bridget Williams Military Health Care Provider 7050 Air Depot Blvd, Bldg 1094, Tinker Afb, OK 73145-8716 2013-12-19
1568720282 Christopher Grayson Hampton Military Health Care Provider 7050 Air Depot Blvd, Bldg 1094, Tinker Afb, OK 73145-8716 2012-05-01
1831407006 James Allan Pickren Military Health Care Provider 5700 Arnold St, Tinker Afb, OK 73145-8105 2010-09-21
1497084180 Nancy M. Chavez-mozingo Military Health Care Provider 7050 Air Depot Blvd, Tinker Afb, OK 73145-8716 2009-12-09
1255575577 Stuart Scott Smith Military Health Care Provider 5700 Arnold St, Tinker Afb, OK 73145-8105 2009-04-30
1508000282 Axelandra Tamar Sang Military Health Care Provider 5700 Arnold St, Bldg 5801, Tinker Afb, OK 73145 2009-04-27
1811131980 Jackie Glen Whitten Jr. Military Health Care Provider 5700 Arnold St, Bldg 5801, Tinker Afb, OK 73145-8105 2009-04-21
1083857189 Jeanne Ann Lewis Military Health Care Provider 5700 Arnold St, Bldg 5801, Tinker Afb, OK 73145-8105 2009-04-20
1417190513 Yamily Cruz Soto Military Health Care Provider 5700 Arnold St Bldg 5801, Tinker Afb, OK 73145-8105 2009-04-20
Find all providers in TINKER AFB

Competitor

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City TINKER AFB
Zip Code 73145

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Dataset Information

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.

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