Individual
KATHLEEN G GORDON
Active
Individual
KATHLEEN G GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
200301119
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0800622
UNITED HEALTHCARE
NC
01
—
1366A
BCBS NC
NC
01
—
2129642
MAMSI
NC
01
—
31770
OPTICARE
NC
01
—
5177534
AETNA
NC
01
—
805415
PARTNERS
NC
05
—
891366A
—
NC
01
—
D5541
MEDCOST
NC
Enumeration date
08/03/2005
Last updated
12/09/2014
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