Organization
SOUTHERN MEDICAL ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY K GORDON MD (PRESIDENT/PHYSICIAN)
87071816128506053
Entity
Organization
Contact information
Practice address
6810 S HAZEL ST, PINE BLUFF, AR 71603-7828
(870) 541-0342
(870) 850-2946
Mailing address
123 NOYANT DR, LITTLE ROCK, AR 72223-5078
(870) 541-0342
(870) 850-2946
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E1629
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184916002
—
AR
Enumeration date
08/05/2010
Last updated
02/24/2014
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