Individual
DR. ALENA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
6330 PRIMROSE HILL CT, NORCROSS, GA 30092-4544
(404) 365-0160
(770) 903-0169
Mailing address
PO BOX 769609, ROSWELL, GA 30076-8224
(404) 365-0160
(770) 903-0169
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD001086
GA
213EP1101X
Primary Podiatric Medicine Podiatrist
POD001086
GA
213ES0131X
Foot Surgery Podiatrist
POD001086
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150488645D
—
GA
01
—
1609816123
GEORGIA CLINIC PC GROUP NPI #
GA
Enumeration date
07/12/2006
Last updated
05/05/2016
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