Organization
M.D. GORDON O.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D GORDON O.D. (PRESIDENT)
(316) 788-2020
Entity
Organization
Contact information
Practice address
1221 N ROCK RD, DERBY, KS 67037-3678
(316) 788-2020
(316) 788-7451
Mailing address
1221 N ROCK RD, DERBY, KS 67037-3678
(316) 788-2020
(316) 788-7451
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1046-3
KS
Other
Enumeration date
01/12/2011
Last updated
10/19/2016
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