Individual
DR. WADE TRAVIS GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 887-2841
(570) 887-2364
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
221155
NY
207X00000X
Orthopaedic Surgery Physician
Primary
MD469347
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
221155
STATE MEDICAL LICENSE
NY
Enumeration date
10/18/2005
Last updated
03/15/2021
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