Individual
GORDON ALEXANDER HASKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
549 E FAIR ST, BLOOMBURG HOSPITAL, BLOOMSBURG, PA 17815
(717) 387-2115
Mailing address
3141 NW 63RD, SUITE 4, OKLAHOMA CITY, OK 73116
(405) 607-1318
(405) 607-1326
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD37149E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011180410002
—
PA
01
—
50060527
CAPITAL BLUE CROSS
PA
01
—
HA40669
HIGHMARK BLUE SHIELD
PA
Enumeration date
07/31/2006
Last updated
07/08/2007
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