Gordon, John B
Gordon, John B is an individual health care provider with primary practice located at 9000 W Wisconsin Ave Pediatric Special Needs, Milwaukee WI 53226-4874. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, which is considered as his primary health care specialty. Gordon, John B can be contacted via phone (414) 266-6943.Contact Information
Primary practice address
9000 W Wisconsin Ave Pediatric Special Needs
Milwaukee WI 53226-4874
Phone: (414) 266-6943
Fax: (414) 266-2926
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | 37665 | Wisconsin |
Profile Details
| NPI number | 1558312355 |
|---|---|
| LBN Legal business name | Gordon, John B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 15th, 2006 |
| Last updated | Nov 19th, 2013 - about 11 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 | 1558312355 | NPPES |
| Wisconsin | MEDICAID | 1558312355 | |
| Wisconsin | Other | 000011354C |
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