Individual
DR. RYAN WESLEY GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
135 W RAVINE RD STE 5-B, KINGSPORT, TN 37660-3847
(423) 224-3460
(423) 224-3465
Mailing address
PO BOX 535744, ATLANTA, GA 30353-5510
(844) 294-5114
(865) 691-0843
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
102141
GA
207L00000X
Anesthesiology Physician
50912
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104125707
—
VA
05
—
Q014177
—
TN
Enumeration date
03/22/2011
Last updated
04/30/2025
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