Individual
TRACIE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 MAIN ST, WINFIELD, KS 67156-2859
(620) 221-4772
Mailing address
3 BLACK HEATH CT, WINFIELD, KS 67156-6301
(620) 222-2593
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
1164606919
KS
Other
Enumeration date
10/31/2019
Last updated
10/31/2019
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