Individual
PAUL H GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1010 4TH ST SW, MASON CITY, IA 50401-2857
(641) 422-6020
(641) 422-7803
Mailing address
621 S ILLINOIS AVE, SUITE 103, MASON CITY, IA 50401-5489
(641) 494-3041
(641) 494-3059
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20471
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0150425
—
IA
01
—
12236
WELLMARK
IA
Enumeration date
08/22/2006
Last updated
07/08/2007
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