Individual
JUDITH LOENE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1920 JOHN WESLEY AVE, COLLEGE PARK, GA 30337
(404) 765-4224
(404) 765-4149
Mailing address
99 JESSE HILL JR DR SE, ATLANTA, GA 30303
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R71791
GA
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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