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Individual
DR. JEFFERY S GORDON
Active
Individual
DR. JEFFERY S GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD11542
TN
208M00000X
Hospitalist Physician
Primary
11542
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3179587
—
TN
01
—
370017664
RAILROAD MEDICARE PIN
—
01
—
4057650
BLUE CROSS BLUE SHIELD TN
TN
Enumeration date
05/23/2005
Last updated
12/16/2016
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