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Organization

CHARLES R GORDON, MD, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES GORDON M.D. (OWNER)
(036) 531-8239
Entity
Organization

Contact information

Practice address
5016 GILMER RD, LONGVIEW, TX 75604-9666
(903) 653-1823
(903) 653-1822
Mailing address
PO BOX 6605, TYLER, TX 75711-6605
(903) 363-1550
(903) 595-1592

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
208VP0000X
Pain Medicine Physician

Other

Enumeration date
07/30/2014
Last updated
11/22/2022
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