Gordon, Douglas M
Gordon, Douglas M is an individual health care provider with primary practice located at 701 W Cocoa Beach Cswy , Cocoa Beach FL 32931-3585. He recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Gordon, Douglas M can be contacted via phone (321) 799-7111.Contact Information
Primary practice address
701 W Cocoa Beach Cswy
Cocoa Beach FL 32931-3585
Phone: (321) 799-7111
Fax: (770) 621-3181
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | ME64194 | Florida |
| Allopathic & Osteopathic Physicians / Nuclear Radiology | 2085N0904X | ME64194 | Florida |
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | ME64194 | Florida |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME64194 | Florida |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | ME64194 | Florida |
| Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X | ME64194 | Florida |
Profile Details
| NPI number | 1144397217 |
|---|---|
| LBN Legal business name | Gordon, Douglas M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 30th, 2006 |
| Last updated | Aug 5th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144397217 | NPPES |
| Florida | Other | 23388 | BCBS |
| Florida | Other | 300048844 | BCBS |
| Florida | Other | 23388Z | BCBS |
| Florida | MEDICAID | 377261600 | BCBS |
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