Individual
DR. BARRY M GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
411 COMMERCIAL CT STE A, VENICE, FL 34292-1650
(941) 484-5451
(941) 484-5453
Mailing address
411 COMMERCIAL CT STE A, VENICE, FL 34292-1650
(941) 484-5451
(941) 484-5453
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35-04-8104G
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0553118
—
OH
Enumeration date
06/09/2005
Last updated
03/10/2016
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