Gordon, Jeffery D

Gordon, Jeffery D is an individual health care provider with primary practice located at 1100 N Kentucky Ave , West Plains MO 65775-2029. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Gordon, Jeffery D can be contacted via phone (417) 257-6713.

Contact Information

Primary practice address
1100 N Kentucky Ave West Plains MO 65775-2029
Phone: (417) 257-6713
Fax: (417) 257-5878
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X 45986 Minnesota
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 45986 Minnesota

Profile Details

NPI number 1477531838
LBN Legal business name Gordon, Jeffery D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2006
Last updated Jul 21st, 2022 - about 2 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 1477531838 NPPES
Minnesota MEDICAID 098444200
Minnesota MEDICAID 1477531838
Minnesota MEDICAID 218633001

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