Individual
TIMOTHY GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8072
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8072
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS52337
FL
Other
Enumeration date
08/06/2014
Last updated
02/20/2019
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