Organization
MICHAEL D GORDON OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D GORDON OD (PRESIDENT)
(316) 684-2020
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
10462 MICHAEL D GORD
KS
Other
Enumeration date
10/04/2006
Last updated
02/25/2008
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