Individual
RICHARD G GORDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5009 RIVER CHASE DR, BLDG 100 SUITE C, PHENIX CITY, AL 36867-7425
(334) 291-5125
(334) 291-9956
Mailing address
5009 RIVERCHASE DRIVE, BUILDING 400 SUITE B, PHENIX CITY, AL 36867
(334) 291-5125
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
SA51TA630
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009931305
—
AL
01
—
51521264
BC
AL
Enumeration date
07/05/2006
Last updated
06/03/2019
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