| Michael C. Gordon, Md, Llc | |
|
4015 S Cobb Dr Se Suite 220 Smyrna GA 30080-6303 | |
| (770) 801-0980 | |
| (770) 801-9039 |
| Full Name | Michael C. Gordon, Md, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Medicine |
| Location | 4015 S Cobb Dr Se, Smyrna, Georgia |
| Authorized Official Name and Position | Michael C Gordon (OWNER) |
| Authorized Official Contact | 7708010980 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael C. Gordon, Md, Llc 4015 S Cobb Dr Se Suite 220 Smyrna GA 30080-6303 Ph: (770) 801-0980 | Michael C. Gordon, Md, Llc 4015 S Cobb Dr Se Suite 220 Smyrna GA 30080-6303 Ph: (770) 801-0980 |
| NPI Number | 1598957011 |
|---|---|
| Provider Enumeration Date | 08/17/2007 |
| Last Update Date | 08/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598957011 | NPI | - | NPPES |
| 461679 | Other | GA | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | 026534 (Georgia) | Primary |
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