Individual
DEREK MICHAEL GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2809 DENNY AVE, PASCAGOULA, MS 39581-5301
(228) 809-5000
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(228) 497-8874
(228) 497-8869
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
19264
MS
207P00000X
Emergency Medicine Physician
25109
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1U20883
—
LA
Enumeration date
03/14/2006
Last updated
12/02/2013
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