Gordon, Peter Alfred
Gordon, Peter Alfred is an individual health care provider with primary practice located at 1457 Scott Blvd , Decatur GA 30030-1705. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Gordon, Peter Alfred can be contacted via phone (404) 292-2500.Contact Information
Primary practice address
1457 Scott Blvd
Decatur GA 30030-1705
Phone: (404) 292-2500
Fax: (404) 294-9361
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 023055 | Georgia |
Profile Details
| NPI number | 1992706683 |
|---|---|
| LBN Legal business name | Gordon, Peter Alfred |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2005 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1992706683 | NPPES |
| Georgia | MEDICAID | 00283786A |
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