Gordon, Kenneth Bryce

Gordon, Kenneth Bryce is an individual health care provider with primary practice located at 4811 S Laburnum Ave , Richmond VA 23231-2713. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gordon, Kenneth Bryce can be contacted via phone (804) 226-1144.

Contact Information

Primary practice address
4811 S Laburnum Ave Richmond VA 23231-2713
Phone: (804) 226-1144
Fax: (804) 236-9026
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 0618000495 Virginia

Profile Details

NPI number 1497752208
LBN Legal business name Gordon, Kenneth Bryce
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated May 21st, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497752208 NPPES
Virginia Other DA5536 RAILROAD MEDICARE PIN
Virginia Other U84594 RAILROAD MEDICARE PIN
Virginia Other 541783118 RAILROAD MEDICARE PIN
Virginia MEDICAID 9232362 RAILROAD MEDICARE PIN
Virginia Other 541783118 RAILROAD MEDICARE PIN
Virginia Other P00068065 RAILROAD MEDICARE PIN

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