Individual
DENNIS DEWAYNE GORDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1721 W 18TH ST, SPENCER, IA 51301
(712) 262-8878
(712) 262-8807
Mailing address
PO BOX 420, 1721 W 18TH ST, SPENCER, IA 51301-0420
(712) 262-8878
(712) 262-8807
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
19347
IA
207W00000X
Ophthalmology Physician
33427
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0148312
—
IA
Enumeration date
07/08/2005
Last updated
07/08/2007
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