Organization
MICHAEL D GORDON OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D GORDON OD (PRESIDENT)
(316) 684-2020
Entity
Organization
Contact information
Practice address
110 N WASHINGTON AVE, WELLINGTON, KS 67152-3949
(620) 326-2020
(620) 326-6350
Mailing address
110 N WASHINGTON AVE, WELLINGTON, KS 67152-3949
(620) 326-2020
(620) 326-6350
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10462 MICHAEL D GORD
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD8359
RAILROAD MEDICARE
—
Enumeration date
10/04/2006
Last updated
08/22/2020
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