Gordon, Mark Ernest

Gordon, Mark Ernest is an individual health care provider with primary practice located at 2700 Clay Edwards Dr Suite 400, North Kansas City MO 64116-3251. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Gordon, Mark Ernest can be contacted via phone (816) 421-4240.

Contact Information

Primary practice address
2700 Clay Edwards Dr Suite 400 North Kansas City MO 64116-3251
Phone: (816) 421-4240
Fax: (816) 421-5015
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X R1D12 Missouri

Profile Details

NPI number 1083686257
LBN Legal business name Gordon, Mark Ernest
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated Dec 17th, 2014 - about 10 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 1083686257 NPPES
Other 10000045 BCBS OF KC INDIVIDUAL
MEDICAID 201851839 BCBS OF KC INDIVIDUAL
Other 110086289 BCBS OF KC INDIVIDUAL

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