Taxonomy Code 1710I1002X(1710i1002x)
Independent Duty Corpsman. Providers: 43
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Independent Duty Corpsman Providers
| NPI | Name | Type | Address |
|---|---|---|---|
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Jenesia Arielle Dillow Ordonia |
Individual |
3158b Holloway Dr Gulfport, MS |
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IDC Heather Ann Watts |
Individual |
5501 Marvin Shields Blvd Gulfport, MS |
|
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IDC Montoya Demont Gunn |
Individual |
1801 Fuller Rd Suite A-01 Meridian, MS |
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MR. SFIDC Thomas Jeffrey Ruffner |
Individual |
5503 Marvin Shields Blvd Nhbc Gulfport Gulfport, MS |
|
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MR. IDC Justin Ray Lancaster |
Individual |
5301 Bainbridge Ave Gulfport, MS |
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Jesse Lee Palacios II |
Individual |
5501 Marvin Shields Blvd Gulfport, MS |
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Samuel Leroy Graham |
Individual |
14115 Fred And Al Key Rd Kiln, MS |
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SURFACE IDC Nathan Daniel Dejager |
Individual |
5501 Marvin Shields Blvd Gulfport, MS |
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MR. IDC David Alexander Glenn JR. |
Individual |
5501 Marvin Shields Blvd Gulfport, MS |
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IDC Jeremiah John Baldwin |
Individual |
5303 Marvin Shields Blvd Gulfport, MS |
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MILITARY PROVIDER Robert Dale Baker |
Individual |
2603 Lower Gainesville Rd Stennis Space Center, MS |
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MR. IDC James Patrick Sonnier |
Individual |
2603 Lower Gainesville Rd Stennis Space Center, MS |
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MR. Thomas William Holder |
Individual |
Medical Department, 2000 Jerry St Pe Hwy Pascagoula, MS |
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MR. IDC Trevor James Trout |
Individual |
2603 Lower Gainesville Rd Stennis Space Center, MS |
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SFIDC Matthew Coleman |
Individual |
Nbhc Naval Construction Battalion Center Gulfport 5501 Marvin Shields Blvd Gulfport, MS |
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IDC Jeffrey Alexander Leemauk |
Individual |
4010a Blue Heron Way Gulfport, MS |
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Michael Alexander Boartfield |
Individual |
4033a Mallard Cv Gulfport, MS |
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Bradley Craig Wilson |
Individual |
2807 Montclair Ave Pascagoula, MS |
|
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Nicolas Riley |
Individual |
5501 Marvin Shields Blvd. Gulfport, MS |
|
|
IDC Rowdy Pameticky |
Individual |
952 Poni Pl Diamondhead, MS |
How to obtain, renew, or terminate an NPI
Every health care provider, whether it’s a hospital, pharmacy, or individual specialist, must obtain their own NPI number. This identification number is unique and is assigned upon application. In tod...
| Taxonomy Code | 1710I1002X |
| Specialization | Independent Duty Corpsman |
| Display Name | Independent Duty Corpsman |
| Taxonomy Group | Other Service Providers |
| Taxonomy Classification | Military Health Care Provider |
| Definition | A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Effective Date | September 30, 2009 |