Individual
DR. ROBERT L GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5174 BLAZER PARKWAY, DUBLIN, OH 43017
(614) 792-9104
(614) 792-2382
Mailing address
5174 BLAZER PARKWAY, DUBLIN, OH 43017
(614) 792-9104
(614) 792-2382
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4346
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000119574
ANTHEM BC BS
—
01
—
0026591
TRICARE
—
05
—
0815523
—
OH
01
—
113095
MHN
—
01
—
542647
ANHEUSER BUSCH
—
Enumeration date
01/19/2007
Last updated
03/08/2012
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