DR. GORDON MICHAEL TELEPUN (NPI# 1932267218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932267218 |
| Entity Type | Individual |
| Full Name | DR. GORDON MICHAEL TELEPUN |
| Credential | MD |
| Practice Address |
1206 Somerville Rd Se Decatur AL 35601 |
| Practice Telephone | 2563405188 |
| Practice Fax Number | 2563405192 |
| Mailing Telephone | 2563405188 |
| Mailing Fax Number | 2563405192 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2019-06-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
17201 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 000085141 | 05 | |
| AL | BLUE CROSS | 51085141TEL | 01 |
| Street Address |
1206 SOMERVILLE RD SE |
| City | DECATUR |
| State | AL |
| Zip Code | 35601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376000679 | Monica Dawn Ross | Counselor | 106 Lee St. Ne, Suite C, Decatur, AL 35601 | 2019-02-23 |
| 1063950319 | Samantha Elizabeth Pickett | Nurse Practitioner | 1115 Beltline Rd Se, Ste 400, Decatur, AL 35601 | 2017-02-07 |
| 1497208250 | Beronica Goodwin | Home Health Aide | 1102b Suite #2 4th Ave Se, Decatur, AL 35601 | 2016-07-28 |
| 1770957177 | Xochitl Dupre | Obstetrics & Gynecology | 1874 Beltline Road Sw, Suite 105, Decatur, AL 35601 | 2015-11-23 |
| 1104224708 | River City Psychiatry, Inc. | Community/Behavioral Health | 115 Johnston Street, Se, Suite 202, Decatur, AL 35601 | 2014-12-12 |
| 1760882690 | Derrick Aaron Randolph | Registered Nurse | 1207 7th St S.e., Decatur/morgan Hospital - Parkway Campus, Decatur, GA 35601 | 2014-08-28 |
| 1427465434 | Martha Read | Family Medicine | 2208 Danville Rd Sw Ste A, Decatur, AL 35601 | 2014-07-22 |
| 1205242948 | Pure Heart Home Care of Alabama, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 107 B 14th Street Sw, Decatur, AL 35601 | 2014-07-02 |
| 1720492242 | Christopher John Phillips | Emergency Medicine | 1201 7th Street Se, Decatur, AL 35601 | 2014-06-12 |
| 1366794711 | Complete Dental Decatur LLC | Dentist | 1241 Point Mallard Parkway, Suite. 105, Decatur, AL 35601 | 2012-10-10 |
| Find all providers in zip 35601 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831360296 | Premier Plastic Surgery Associates, LLC | Surgery | 2675 N Decatur Rd, Suite 501, Decatur, GA 30033-6131 | 2008-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780056945 | Melanie Petro Md LLC | Surgery | 905 Moontgomery Highway, Birmingham, AL 35216 | 2015-10-28 |
| 1316100670 | Patrick C Wilson | Surgery | 805 Madison St., Suite 1d, Huntsville, AL 35801 | 2008-07-08 |
| 1366629917 | Jeffery L Walding | Surgery | 2800 Ross Clark Cir Ste 2, Dothan, AL 36301-9917 | 2008-01-25 |
| 1639372725 | Justin Parish Martin | Surgery | 2431 W Main St Ste 302, Dothan, AL 36301-1251 | 2007-06-07 |
| 1245456805 | Michael D. Yates, Md, PC | Surgery | 303 Williams Av Sw, Suite 1421, Huntsville, AL 35801-6008 | 2007-04-18 |
| 1114062106 | Luther Dwight Baker | Surgery | 105 Professional Ln, Dothan, AL 36303-3875 | 2007-02-20 |
| 1316014681 | Plastic Surgery Inc | Surgery | 701 University Blvd Medical Tower, Suite 902, Tuscaloosa, AL 35401 | 2006-11-29 |
| 1326066010 | Randy D. Proffitt, M.d., LLC | Surgery | 6317 Piccadilly Square Dr, Mobile, AL 36609-5103 | 2006-07-18 |
| 1528085347 | Randy Douglas Proffitt | Surgery | 740 Hillcrest Rd, Suite C, Mobile, AL 36695-3924 | 2006-07-16 |
| 1871531681 | Curtis N Harris | Surgery | 1601, Ste 2n, Mobile, AL 36604-1512 | 2006-06-03 |
| Find all providers with the same taxonomy | ||||
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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.