Individual
NEIL E GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2370 ROCKMART HWY, SUITE 100, CEDARTOWN, GA 30125-6029
(770) 748-7818
Mailing address
420 E 2ND AVE STE 103, ROME, GA 30161-3210
(706) 509-3000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22411
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000213386C
—
GA
Enumeration date
03/14/2006
Last updated
03/10/2023
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