Mark Dunham (NPI# 1861865743, PAC ID# 7113229501) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1861865743 |
| PAC ID by PECOS | 7113229501 |
| Professional Enrollment ID | I20151231000112 |
| Full Name | Mark Dunham |
| Organization Legal Name | SOUTHERN ORTHOPAEDICS AND SPORTS MEDICINE, P.C. |
| Address |
3231 Glynn Ave Brunswick GA 31520-4851 |
| Phone Number | 9122659006 |
| Gender | M |
| Medical School | UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE |
| Graduation Year | 2015 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 7911983911 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110025 | SOUTHEAST GEORGIA HEALTH SYSTEM- BRUNSWICK CAMPUS |
| Address | Phone | Organization |
|---|---|---|
| 3231 Glynn Ave, Brunswick, GA 31520-4851 | 9122659006 | SOUTHERN ORTHOPAEDICS AND SPORTS MEDICINE, P.C. |
| Organization Legal Name | SOUTHERN ORTHOPAEDICS AND SPORTS MEDICINE, P.C. |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Dunn | Orthopedic Surgery | Southern Orthopaedics and Sports Medicine, P.C. | 3231 Glynn Ave, Brunswick, GA 31520-4851 |
| Richard B Burrell | Physician Assistant | Southern Orthopaedics and Sports Medicine, P.C. | 3231 Glynn Ave, Brunswick, GA 31520-4851 |
| Richard C Sipe | Physician Assistant | Southern Orthopaedics and Sports Medicine, P.C. | 3231 Glynn Ave, Brunswick, GA 31520-4851 |
| Jackie K Brooks | Orthopedic Surgery | Southern Orthopaedics and Sports Medicine, P.C. | 3231 Glynn Ave, Brunswick, GA 31520-4851 |
| Raymond F Topp | Orthopedic Surgery | Southern Orthopaedics and Sports Medicine, P.C. | 3231 Glynn Ave, Brunswick, GA 31520-4851 |
| Ralph Morales | Orthopedic Surgery | Southern Orthopaedics and Sports Medicine, P.C. | 3231 Glynn Ave, Brunswick, GA 31520-4851 |
| Nicholas S Richardson | Orthopedic Surgery | Southern Orthopaedics and Sports Medicine, P.C. | 3231 Glynn Ave, Brunswick, GA 31520-4851 |
| Street Address |
3231 GLYNN AVE |
| City | BRUNSWICK |
| State | GA |
| Zip | 31520-4851 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Dunn | Orthopedic Surgery | Southern Orthopaedics and Sports Medicine, P.C. | 3231 Glynn Ave, Brunswick, GA 31520-4851 |
| Richard B Burrell | Physician Assistant | Southern Orthopaedics and Sports Medicine, P.C. | 3231 Glynn Ave, Brunswick, GA 31520-4851 |
| Richard C Sipe | Physician Assistant | Southern Orthopaedics and Sports Medicine, P.C. | 3231 Glynn Ave, Brunswick, GA 31520-4851 |
| Jackie K Brooks | Orthopedic Surgery | Southern Orthopaedics and Sports Medicine, P.C. | 3231 Glynn Ave, Brunswick, GA 31520-4851 |
| Raymond F Topp | Orthopedic Surgery | Southern Orthopaedics and Sports Medicine, P.C. | 3231 Glynn Ave, Brunswick, GA 31520-4851 |
| Ralph Morales | Orthopedic Surgery | Southern Orthopaedics and Sports Medicine, P.C. | 3231 Glynn Ave, Brunswick, GA 31520-4851 |
| Nicholas S Richardson | Orthopedic Surgery | Southern Orthopaedics and Sports Medicine, P.C. | 3231 Glynn Ave, Brunswick, GA 31520-4851 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gregory D Martin | General Surgery | 650 Scranton Rd, Suite C, Brunswick, GA 31520-1927 | |
| Kerry E Moore | Nurse Practitioner | Heller Family Medicine LLC | 664 Scranton Rd, Brunswick, GA 31520-1946 |
| Richard P Mcewan | Family Medicine | 160 Juniper Court, Suite 101, Brunswick, GA 31520-1952 | |
| Sonya D Roland | Physical Therapy | 216 Harrison Ln, Brunswick, GA 31520-1959 | |
| Yoshi T Graham | Nurse Practitioner | Gateway Behavioral Health Services | 600 Coastal Village Dr, Brunswick, GA 31520-1973 |
| Dana Morgan | Nurse Practitioner | Gateway Behavioral Health Services | 600 Coastal Village Dr, Brunswick, GA 31520-1973 |
| Stephanie R Chapman | Psychiatry | Gateway Behavioral Health Services | 600 Coastal Village Dr, Brunswick, GA 31520-1973 |
| Gregory C Claxton | Nurse Practitioner | Gateway Behavioral Health Services | 600 Coastal Village Dr, Brunswick, GA 31520-1973 |
| Megan J Woolwine | Nurse Practitioner | Gateway Behavioral Health Services | 600 Coastal Village Dr, Brunswick, GA 31520-1973 |
| Peri M Kyriacos | Clinical Social Worker | Gateway Behavioral Health Services | 600 Coastal Village Dr, Brunswick, GA 31520-1973 |
| Find all physicians in zip 31520 | |||
| City | BRUNSWICK |
| Zip Code | 31520 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | BRUNSWICK + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.