Individual
KAITLIN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 E CHESTNUT ST UNIT 310, LOUISVILLE, KY 40202
(502) 589-6788
(502) 589-5093
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(025) 626-5105
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
52271
KY
390200000X
Student in an Organized Health Care Education/Training Program
52271
KY
Other
Enumeration date
03/24/2016
Last updated
02/04/2020
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