Gordon, Jeffrey A

Gordon, Jeffrey A is an individual health care provider with primary practice located at 100 South St , Southbridge MA 01550. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Gordon, Jeffrey A can be contacted via phone (508) 764-2400.

Contact Information

Primary practice address
100 South St Southbridge MA 01550
Phone: (508) 764-2400
Fax: (508) 909-7770
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 036423 Connecticut

Profile Details

NPI number 1609857119
LBN Legal business name Gordon, Jeffrey A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated Aug 31st, 2018 - 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 1609857119 NPPES
Connecticut MEDICAID 1609857119
Connecticut Other C02844
Connecticut Other 004222600

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