Organization
KRISTA GORDON MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA GELVIN MD (OFFICE MANAGER)
(580) 536-7546
Entity
Organization
Contact information
Practice address
5366 NW CACHE RD, SUITE 6, LAWTON, OK 73505-3353
(580) 536-7546
(580) 581-2051
Mailing address
5366 NW CACHE RD, SUITE 6, LAWTON, OK 73505-3335
(580) 536-7546
(580) 581-2051
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21237
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900522624
MEDICARE PTAN
OK
Enumeration date
05/11/2007
Last updated
03/22/2011
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