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Individual

DONAL KEVIN GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1201 3RD AVE SE, CEDAR RAPIDS, IA 52403-4009
(319) 730-7300
Mailing address
PO BOX 2205, CEDAR RAPIDS, IA 52406-2205
(319) 730-7300

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36376
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0460865
IA
01
P00731432
RR MEDICARE MEMBER
Enumeration date
04/14/2006
Last updated
12/12/2011
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