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Individual

DR. GREGORY ANDREW GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
232 MARKET ST, SUITE 234, FLOWOOD, MS 39232-3339
(601) 214-3539
(601) 914-7201
Mailing address
232 MARKET ST, SUITE 234, FLOWOOD, MS 39232-3339
(601) 214-3539
(601) 914-7201

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
16391
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00120813
MS
05
179088
AL
01
260044396
RAILROAD MEDICARE
MS
01
P00657494
MEDICARE RR
MS
Enumeration date
06/23/2006
Last updated
11/02/2016
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