Individual
DR. THOMAS VINCENT GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
195 ROOSEVELT TRAIL, SOUTH CASCO, ME 04077-0200
(207) 655-2020
(207) 655-7770
Mailing address
PO BOX 200, SOUTH CASCO, ME 04077-0200
(207) 655-2020
(207) 655-7770
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT 760
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039796
ANTHEM
ME
05
—
134240099
—
ME
Enumeration date
11/16/2006
Last updated
07/08/2007
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