Organization
NEIL E GORDON, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL E GORDON MD (PRESIDENT/PHYSICIAN)
(770) 748-7818
Entity
Organization
Contact information
Practice address
1106 N MAIN ST, CEDARTOWN, GA 30125-2039
(770) 748-7818
Mailing address
1106 N MAIN ST, CEDARTOWN, GA 30125-2039
(770) 748-7818
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22411
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000213386A
—
GA
Enumeration date
10/23/2006
Last updated
03/23/2010
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