Gordon, Barry M

Gordon, Barry M is an sole proprietor health care provider with primary practice located at 411 Commercial Ct Ste A , Venice FL 34292-1650. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Gordon, Barry M can be contacted via phone (941) 484-5451.

Contact Information

Primary practice address
411 Commercial Ct Ste A Venice FL 34292-1650
Fax: (941) 484-5453
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 35-04-8104G Ohio

Profile Details

NPI number 1437153368
LBN Legal business name Gordon, Barry M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 9th, 2005
Last updated Mar 10th, 2016 - about 9 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 1437153368 NPPES
Ohio MEDICAID 0553118

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