Gordon, Louis Ira

Gordon, Louis Ira is an individual health care provider with primary practice located at 7810 Wormans Mill Rd Suite C, Frederick MD 21701-3035. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gordon, Louis Ira can be contacted via phone (301) 228-2666.

Contact Information

Primary practice address
7810 Wormans Mill Rd Suite C Frederick MD 21701-3035
Phone: (301) 228-2666
Fax: (301) 228-2119
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X TA0647 Maryland

Profile Details

NPI number 1629075197
LBN Legal business name Gordon, Louis Ira
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2005
Last updated Dec 3rd, 2014 - about 12 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 1629075197 NPPES
Maryland Other 0923640001 DMERC A DME REGION A
Maryland Other 410031313 DMERC A DME REGION A

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