Gordon, Tracy A
Gordon, Tracy A is an individual health care provider with primary practice located at 1205 S Telshor Blvd , Las Cruces NM 88011-4748. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Gordon, Tracy A can be contacted via phone (505) 260-4300.Contact Information
Primary practice address
1205 S Telshor Blvd
Las Cruces NM 88011-4748
Phone: (505) 260-4300
Fax: (505) 260-4338
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 97-63 | New Mexico |
Profile Details
| NPI number | 1942204763 |
|---|---|
| LBN Legal business name | Gordon, Tracy A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2005 |
| Last updated | Jul 9th, 2007 - about 17 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 | 1942204763 | NPPES |
| New Mexico | MEDICAID | Q0054 | |
| New Mexico | Other | NM009V08 |
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