Faulkner, Gordon

Faulkner, Gordon is an individual health care provider with primary practice located at 2002 E Blue Mounds Rd , Mount Horeb WI 53572-2634. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Faulkner, Gordon can be contacted via phone (608) 274-9717.

Contact Information

Primary practice address
2002 E Blue Mounds Rd Mount Horeb WI 53572-2634
Phone: (608) 274-9717
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 22351 Wisconsin

Profile Details

NPI number 1942307962
LBN Legal business name Faulkner, Gordon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Mar 23rd, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942307962 NPPES
Wisconsin MEDICAID 30501900

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