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Organization

SHAWN GORDEN MD, PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHAWN GORDEN MD (PRESDIENT)
(606) 326-0024
Entity
Organization

Contact information

Practice address
617 23RD ST STE 6, ASHLAND, KY 41101-2845
(606) 326-0024
(606) 326-0041
Mailing address
PO BOX 30, ASHLAND, KY 41105-0030
(606) 326-0024
(606) 326-0041

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
39057
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2552545
OH
05
64091820
KY
Enumeration date
05/05/2008
Last updated
05/05/2008
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