Organization
MAXIE GORDON MD & ASSOCIATES, PLLC
Active
Other names
Gordon Medical Arts Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TEANDRA WALTON (DIRECTOR OF BUSINESS OPERATIONS)
(601) 488-8101
Entity
Organization
Contact information
Practice address
590 SPRINGRIDGE RD, CLINTON, MS 39056
(601) 488-8101
(662) 287-5678
Mailing address
590 SPRINGRIDGE RD, CLINTON, MS 39056-5606
(601) 488-8101
(662) 287-5678
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
9801288
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08723392
—
MS
Enumeration date
02/07/2008
Last updated
08/21/2019
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