DR. JACQUES S COUSINEAU (NPI# 1912972514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912972514 |
| Entity Type | Individual |
| Full Name | DR. JACQUES S COUSINEAU |
| Credential | M.D. |
| Practice Address |
340 Magnolia Cir 325 Mdg/sgomf Tyndall A F B FL 32403-5604 |
| Mailing Address |
11 Willwall St Ne Fort Walton Beach FL 32547-1330 |
| Practice Telephone | 8502837501 |
| Mailing Telephone | 8508622069 |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 17925 | AL | Allopathic & Osteopathic Physicians |
| Street Address |
340 MAGNOLIA CIR 325 MDG/SGOMF |
| City | TYNDALL A F B |
| State | FL |
| Zip Code | 32403-5604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831167428 | Tina Maria Nelson | Social Worker | 340 Magnolia Cir, Tyndall A F B, FL 32403-5604 | 2006-03-09 |
| 1316914989 | Orlando Luis Colon | Dentist | 340 Magnolia Cir, Tyndall A F B, FL 32403-5604 | 2006-03-02 |
| 1851367478 | Timothy D. Howerton | Physician Assistant | 340 Magnolia Cir, Tyndall A F B, FL 32403-5604 | 2006-02-23 |
| 1487628384 | 325th Medical Group (usaf) | Clinic/Center | 340 Magnolia Cir, Optometry Clinic, Tyndall A F B, FL 32403-5604 | 2006-02-15 |
| 1427022664 | Lindsay Turner Purvis | Psychologist | 340 Magnolia Cir, Tyndall A F B, FL 32403-5604 | 2006-02-15 |
| 1023082443 | Patricia Joanne Jones | Nurse Practitioner | 340 Magnolia Cir, Tyndall A F B, FL 32403-5604 | 2006-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326408063 | Nathaniel Criddle | Dentist | 325 Aerospace Medicine Sq/sgpd, 340 Magnolia Circle Bldg 1465, Tyndall Afb, FL 32403 | 2016-02-23 |
| 1952730491 | Erick Laron Jackson | Physical Therapist | 325 Mdg/physical Therapy, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2013-11-05 |
| 1972830701 | Quan Tram | Pharmacist | 340 Magnolia Cirlcle, Tyndall Afb, FL 32403 | 2009-11-16 |
| 1952473308 | Robert Allen Frick | Family Medicine | 325th Medical Group 340 Magnolia Circle, Tyndall Afb, Panama City, FL 32403 | 2006-11-14 |
| 1285733907 | 325th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | Magnolia Circle, Tyndall Afb, FL 32403 | 2006-09-21 |
| 1093737272 | Walter Edward Calvo | Social Worker | Bldg 1305 Suwannee Ave, Tyndall Afb, FL 32403 | 2006-07-24 |
| 1790727865 | Michelle Gautreaux | Nutritionist | 325 Mdg, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2006-06-12 |
| 1568436962 | 325 Mdg | Psychologist | 325 Mdg Bldg, 1305 Suwannee Ave, Tyndall Afb, FL 32403 | 2006-02-14 |
| 1780658005 | Brant Casford | Radiology | 325 Mdg/sgsar Radiology, Tyndall Afb, FL 32403 | 2006-02-14 |
| 1215911573 | Rama Bhyravabhotla | Physician Assistant | 325 Mdos/sgomf, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2005-12-01 |
| Find all providers in zip 32403 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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| 1255930871 | Haymee Rodriguez | Family Medicine | 18751 Sw 295th Ter, Homestead, FL 33030-2310 | 2020-10-23 |
| 1033718986 | Jason Wittlin | Family Medicine | 601 Sw 242nd Ter, Newberry, FL 32669-4495 | 2020-10-21 |
| 1457950420 | Paxton Medical Management | Family Medicine | 14279 Tamiami Trl, North Port, FL 34287-2215 | 2020-10-21 |
| 1679172779 | Flagler Family Nursing Home Care LLC | Family Medicine | 130 Healthpark Blvd, St Augustine, FL 32086-5776 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
| City | TYNDALL A F B |
| Zip Code | 32403 |
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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.