Individual
MICHAEL NOLAN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
751 DERBY DR, YORK, AL 36925-2121
(205) 392-5263
Mailing address
751 DERBY DR, YORK, AL 36925-2121
(205) 392-5263
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22660
AL
282N00000X
General Acute Care Hospital
22660
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051552669
—
AL
Enumeration date
08/31/2006
Last updated
12/11/2013
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