Gordon, Gregory Andrew
Gordon, Gregory Andrew is an sole proprietor health care provider with primary practice located at 232 Market St Suite 234, Flowood MS 39232-3339. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Gordon, Gregory Andrew can be contacted via phone (601) 214-3539.Contact Information
Primary practice address
232 Market St Suite 234
Flowood MS 39232-3339
Phone: (601) 214-3539
Fax: (601) 914-7201
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 16391 | Mississippi |
Profile Details
| NPI number | 1639105794 |
|---|---|
| LBN Legal business name | Gordon, Gregory Andrew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 23rd, 2006 |
| Last updated | Nov 2nd, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639105794 | NPPES |
| Alabama | MEDICAID | 179088 | |
| Alabama | MEDICAID | 00120813 | |
| Alabama | Other | 260044396 | |
| Alabama | Other | P00657494 |
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