Individual
MARK GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-3742
(859) 323-5956
(859) 323-1080
Mailing address
425 LEWIS HARGETT CIR, LEXINGTON, KY 40503-3590
(859) 268-1030
(859) 269-4120
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1121654
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
3008454
KY
Other
Enumeration date
12/30/2013
Last updated
09/14/2022
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