Individual
DR. LANCE STEWART GORDON
Active
Individual
DR. LANCE STEWART GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
258288
NY
207L00000X
Anesthesiology Physician
Primary
OS9740
FL
207LP3000X
Pediatric Anesthesiology Physician
OS9740
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002109-00
—
FL
05
—
317169747A
—
GA
01
—
A400055931
MEDICARE
NY
Enumeration date
07/01/2008
Last updated
06/06/2012
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