JUSTIN GRAHAM DOCKENDORF (NPI# 1619070414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619070414 |
| Entity Type | Individual |
| Full Name | JUSTIN GRAHAM DOCKENDORF |
| Credential | MD |
| Practice Address |
3100 Dutch Forest Ln Edmond OK 73013-7577 |
| Practice Telephone | 4057063019 |
| Mailing Telephone | 4057063019 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2008-04-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 23662 | OK | Allopathic & Osteopathic Physicians |
| Street Address |
3100 DUTCH FOREST LN |
| City | EDMOND |
| State | OK |
| Zip Code | 73013-7577 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461866 | Alison Church-pugh | Case Manager/Care Coordinator | 1441 Kelley Pointe Pkwy, Edmond, OK 73013 | 2020-09-12 |
| 1699395343 | Dental Specialists of Edmond | Dentist | 16430 Muirfield Pl, Edmond, OK 73013 | 2020-04-23 |
| 1104477215 | Kammerer Richey LLC | Nurse Practitioner | 902 Nw 139th Street Parway, Edmond, OK 73013 | 2019-09-20 |
| 1811459191 | Peak Movement Centre, Pllc | Clinic/Center | 13816 Santa Fe Crossing Dr, Edmond, OK 73013 | 2019-04-04 |
| 1851858492 | Luma Hilal | Pharmacist | 2228 Nw 15th Terrace, Edmond, OK 73013 | 2019-03-01 |
| 1578031571 | Oklahoma Wellness Group LLC | Internal Medicine | 14101 North Esatern Avenue Suite B, Edmond, OK 73013 | 2018-11-07 |
| 1477034395 | Specialty Care Pediatrics, Inc. | Home Health | 2256 Nw 164th Street, Edmond, OK 73013 | 2018-08-28 |
| 1972083921 | Pooja Bhakta | Physician Assistant | Stanbro Healthcare Group LLC, 2000 E. 15th St., Suite 400-a, Edmond, OK 73013 | 2018-08-20 |
| 1417460577 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 15103 N Macarthur Blvd, Oklahoma City, OK 73013 | 2017-11-13 |
| 1356879753 | Shawn Smith Optimal Pt and Performance, Pllc | Physical Therapist | 336 Ne 145th Pl, Edmond, OK 73013 | 2017-05-30 |
| Find all providers in zip 73013 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376052381 | Catherine Loeffler | Emergency Medicine | 1609 Breckenridge Dr, Edmond, OK 73013-7667 | 2017-09-21 |
| 1164894499 | Istishfa Pllc | Emergency Medicine | 15520 Monarch Ln, Edmond, OK 73013-1134 | 2015-10-26 |
| 1811374770 | Sarfraz Ahmed | Emergency Medicine | 412 Santa Fe Ter, Edmond, OK 73012-4452 | 2015-04-29 |
| 1790097798 | Guy Lander Peterson | Emergency Medicine | 8125 Ne 139th St, Edmond, OK 73013-8703 | 2010-07-07 |
| 1225368350 | Fastcare Medical Clinic of Edmond | Emergency Medicine | 912 Nw 150th St, Edmond, OK 73013-1829 | 2010-01-13 |
| 1639100035 | James R. Kennedye | Emergency Medicine | 908 Fox Hill Dr, Edmond, OK 73034-7317 | 2006-07-05 |
| 1811928351 | Karunesh Singhal | Emergency Medicine | 15312 Grayson Dr, Edmond, OK 73013-2652 | 2006-07-05 |
| 1881632537 | Gina Lyn Ressler | Emergency Medicine | 1300 E 9th St, Suite 7, Edmond, OK 73034-5756 | 2006-06-03 |
| 1154858645 | Jennifer Si Li | Emergency Medicine | 16400 N May Ave, Edmond, OK 73013-8971 | 2017-05-16 |
| 1063755023 | Questcare Em Oklahoma LLC | Emergency Medicine | 1 S Bryant Ave, Edmond, OK 73034-6309 | 2013-03-28 |
| Find all providers in EDMOND | ||||
Please comment or provide details below to improve the information on JUSTIN GRAHAM DOCKENDORF.
| 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.