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:
Health care specialties
| Specialty | Code | License # | 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 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811076938 | NPPES |
| Mississippi | MEDICAID | 04124592 |
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