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Contact Information

JEFFERY D GORDON, MD
1100 N KENTUCKY AVE
WEST PLAINS, MO65775-2029
 Phone: 417-257-6713
 Fax: 417-257-5878
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
 

Neuroradiology

2085N0700X
Indicates primary specialty

NPI Profile & details for JEFFERY D GORDON · (Male)

NPI Number 1477531838
Status Active
Credentials MD
Entity Individual
Enumeration date 01/05/2006
Last updated 09/25/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MN License # 45986
  • MO License # 2017001081
  • AR Medicaid 218633001
  • MN Medicaid 098444200
  • MO Medicaid 1477531838
Hospital affiliation(s)
  • OZARKS MEDICAL CENTER - (Acute Care)
    1100 KENTUCKY AVE
    WEST PLAINS, MO 65775
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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