Individual
DR. AUDREY L. GORDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1106 W JACKSON ST, OZARK, MO 65721-9164
(417) 581-3548
(417) 581-6164
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2005014681
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207381005
—
MO
Enumeration date
10/13/2006
Last updated
05/13/2013
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