Individual
C GORDON HARROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1720 OSAGE RD, DERBY, KS 67037-2090
(316) 789-8222
(316) 789-8449
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
(316) 689-9102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25931
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051670
BCBS
KS
01
—
10030
HPK
KS
01
—
10062
PHS
KS
01
—
12264066
MULTIPLAN
KS
01
—
16980
COVENTRY
KS
Enumeration date
06/30/2006
Last updated
07/13/2007
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