Organization
STEPHEN M. GORDON. D.O., P.C
Active
Other names
Gordon & Maynard
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN M GORDON D.O. (PRESIDENT)
(816) 942-3060
Entity
Organization
Contact information
Practice address
1004 CARONDELET DR, #407, KANSAS CITY, MO 64114-4802
(816) 942-3060
(816) 942-3141
Mailing address
1004 CARONDELET DR, #407, KANSAS CITY, MO 64114-4802
(816) 942-3060
(816) 942-3141
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R9794
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10818069
BLUE CROSS BLUE SHIELD
MO
01
—
14039022
BLUE CROSS BLUE SHIELD
MO
01
—
33375001
BLUE CROSS BLUE SHIELD
MO
Enumeration date
12/13/2006
Last updated
08/22/2020
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