Individual
ROBERT T GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4150 5TH ST, RAPID CITY, SD 57701-6022
(605) 399-4300
(605) 399-4352
Mailing address
4150 5TH ST, RAPID CITY, SD 57701-6022
(605) 399-4300
(605) 399-4352
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
5310
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060031670
RAILROAD MEDICARE
SD
01
—
4995658
BLUE CROSS OF SD
SD
05
—
7301930
—
SD
Enumeration date
06/07/2006
Last updated
12/27/2021
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