Individual
DR. TIMOTHY EUGENE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5701 HERRERA DR, SANTA FE, NM 87507-2677
(505) 424-9139
(505) 424-1384
Mailing address
PO BOX 22683, SANTA FE, NM 87502-2683
(575) 639-4767
(505) 424-1384
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2274
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000P4328
—
NM
Enumeration date
08/14/2006
Last updated
09/27/2013
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