Individual
IRENE M GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1425 UNITY PL, LAFAYETTE, IN 47905-5756
(765) 447-7460
(765) 447-8396
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01031583A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100231660
—
IN
Enumeration date
03/14/2006
Last updated
03/29/2012
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