Gordon, Dudley R

Gordon, Dudley R is an individual health care provider with primary practice located at 8105 Adams Dr , Hummelstown PA 17036-8625. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gordon, Dudley R can be contacted via phone (717) 652-1211.

Contact Information

Primary practice address
8105 Adams Dr Hummelstown PA 17036-8625
Phone: (717) 652-1211
Fax: (717) 652-4948
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD022169E Pennsylvania

Profile Details

NPI number 1245298074
LBN Legal business name Gordon, Dudley R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2006
Last updated May 9th, 2019 - about 6 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 1245298074 NPPES
Pennsylvania MEDICAID 0009053290003
Pennsylvania Other 5126044
Pennsylvania Other 50070215

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