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Individual

DR. CHARLES MARVIN GORDON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1505 DAPHNE AVE, DAPHNE, AL 36526
(251) 625-2663
Mailing address
1505 DAPHNE AVE, DAPHNE, AL 36526-4298
(251) 625-2663

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
MD36872
AL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/11/2011
Last updated
08/01/2018
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