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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639105794 NPPES
Alabama MEDICAID 179088
Alabama MEDICAID 00120813
Alabama Other 260044396
Alabama Other P00657494

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