Dr. Gary G. Gordon
Family Doctor - Geriatric Medicine
1800 12th St
Meridian
, Mississippi 39301-4158
Dr. Gary G. Gordon
Family Doctor - Geriatric Medicine
1800 12th St
Meridian
, Mississippi 39301-4158
(601) 703-9936
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About
Features
Specialties
- Family Doctor - Geriatric Medicine
Languages spoken
- English
Location
First Address
- Dr. Gary G. Gordon
- 1800 12th St
- Meridian, MS
- Zip : 39301-4158
- Fax : (601) 703-9936
- Phone : (601) 703-9265
Second Address
- Dr. Gary G. Gordon
- 1800 12th St
- Meridian, MS
- Zip : 39301-4158
- Fax : (601) 703-9401
- Phone : (601) 703-9265
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QG0300X | Family Doctor - Geriatric Medicine | 07448 | MS |
National Provider Identifier
| NPI | 1124010640 |
|---|---|
| Provider Name | Dr. Gary G. Gordon |
| First Address | Meridian, MS 39301-4158 |
| Second Address | Meridian, MS 39301-4158 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/08/2005 |
| Last Update Date | 06/11/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000039981 | MEDICAID OF AL (01) | AL |
| 0130017 | UNITED HEALTH CARE (01) | MS |
| 04458061 | (05) | MS |
| 080030813 | RAILROAD MEDICARE (01) | |
| 73003105 | BLUE CROSS OF AL (01) | AL |
| D00796 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.