Gordon, Kyle Ford

Gordon, Kyle Ford is an individual health care provider with primary practice located at 970 Lakeland Dr Ste 40 , Jackson MS 39216-4640. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Gordon, Kyle Ford can be contacted via phone (601) 200-4850.

Contact Information

Primary practice address
970 Lakeland Dr Ste 40 Jackson MS 39216-4640
Phone: (601) 200-4850
Fax: (601) 200-4838
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 13240 Mississippi

Profile Details

NPI number 1811076938
LBN Legal business name Gordon, Kyle Ford
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2006
Last updated Feb 26th, 2019 - about 5 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 1811076938 NPPES
Mississippi MEDICAID 04124592

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