Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 33212 | CO |
NPI | 1952445587 |
---|---|
Provider Name | Dr. Lawrence A Gordon |
First Address | Aurora, CO 80014-1618 |
Second Address | Lone Tree, CO 80124-5425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 03/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007818 | KAISER-COMMERCIAL NUMBER (01) | |
01332121 | (05) | CO |
C28055 | (02) | |
C28055 | (02) | CO |