Individual
TERRY A GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
185 W CEDAR ST, AKRON, OH 44307-2400
(330) 376-0500
Mailing address
3963 LOOMIS PKWY, RAVENNA, OH 44266-1800
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
34003220
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0665374
—
OH
01
—
341758848040
CARESOURCE
OH
01
—
729584
BUCKEYE COMMUNITY HEALTH
OH
01
—
Q015531
HOMETOWN HEALTH PLAN
OH
Enumeration date
09/03/2006
Last updated
10/11/2007
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