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Contact Information

GARY G GORDON, DO
1800 12TH ST
MERIDIAN, MS39301-4158
 Phone: 601-703-9265
 Fax: 601-703-9401
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for GARY G GORDON · (Male)

NPI Number 1124010640
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 08/19/2005
Last updated 11/06/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • MS License # 07448
  • MS Medicaid 04458061
  • Other 080030813 RAILROAD MEDICARE
  • AL Other 73003105 BLUE CROSS OF AL
  • AL Other 000039981 MEDICAID OF AL
  • MS Other 0130017 UNITED HEALTH CARE
Hospital affiliation(s) Not Available
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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