Individual
RONNY KEITH GORDON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
13509 N MERIDIAN AVE, OKLAHOMA CITY, OK 73120-8397
(405) 937-7422
(405) 848-3591
Mailing address
475 GRIGSBY ST, NEWCASTLE, OK 73065-5950
(405) 361-9614
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0105864
OK
Other
Enumeration date
06/12/2020
Last updated
12/21/2021
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