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Individual

DR. GORDON M. FORWARD

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
1017 MEDICAL CENTER PKWY, SELMA, AL 36701-6780
(334) 875-2100
(334) 418-6540
Mailing address
PO BOX 681628, PRATTVILLE, AL 36068-1628
(334) 875-2100
(334) 418-6540

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
265C
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6273859
UBH - BASIC SERVICES
AL
01
6274859
UBH - PLUS SERVICES
AL
Enumeration date
05/11/2006
Last updated
07/09/2007
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