Gregory Gordon Md, Pllc | |
232 Market St Suite 234 Flowood MS 39232-3339 | |
(601) 214-3539 | |
(601) 914-7201 |
Full Name | Gregory Gordon Md, Pllc |
---|---|
Speciality | Psychiatry & Neurology |
Location | 232 Market St, Flowood, Mississippi |
Authorized Official Name and Position | Gregory Andrew Gordon (OWNER) |
Authorized Official Contact | 6012143539 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Gregory Gordon Md, Pllc Po Box 5215 Brandon MS 39047-5215 Ph: (601) 214-3539 | Gregory Gordon Md, Pllc 232 Market St Suite 234 Flowood MS 39232-3339 Ph: (601) 214-3539 |
NPI Number | 1699210401 |
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Provider Enumeration Date | 01/03/2017 |
Last Update Date | 01/03/2017 |
Medicare PECOS PAC ID | 9133402522 |
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Medicare Enrollment ID | O20170209000407 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699210401 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 16391 (Mississippi) | Primary |
Provider Name | Gregory A Gordon |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1639105794 PECOS PAC ID: 7719068147 Enrollment ID: I20080111000196 |
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