Gordon, Mark R

Gordon, Mark R is an individual health care provider with primary practice located at 4520 W 69Th St North Central Heart Institute, Sioux Falls SD 57108. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Gordon, Mark R can be contacted via phone (605) 977-5000.

Contact Information

Primary practice address
4520 W 69Th St North Central Heart Institute Sioux Falls SD 57108
Phone: (605) 977-5000
Fax: (605) 977-5377
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD220295 Oregon
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 3929 South Dakota

Profile Details

NPI number 1982652939
LBN Legal business name Gordon, Mark R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated May 29th, 2024 - about last year

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 1982652939 NPPES
Iowa Other 33333 IA BCBS #
Iowa Other 3929 IA BCBS #
Iowa Other 931451030123 IA BCBS #
Iowa Other 0008426 IA BCBS #
Iowa Other 10492 IA BCBS #
Iowa Other 346L9GO IA BCBS #
Iowa Other 25-00667 IA BCBS #
Iowa Other 101T6GO IA BCBS #
Iowa Other 165025 IA BCBS #
Iowa MEDICAID 331503700 IA BCBS #
Iowa MEDICAID 6002892 IA BCBS #
Iowa MEDICAID 0549402 IA BCBS #

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