Individual
MICHAEL EARL GORTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2521 GLENN HENDREN DR, SUITE 306, LIBERTY, MO 64068-3388
(816) 407-5490
(816) 407-5491
Mailing address
PO BOX 219672, KANSAS CITY, MO 64121-9672
(816) 407-5490
(816) 407-5491
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
R4P01
MO
2086S0129X
Vascular Surgery Physician
R4P01
MO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
R4P01
MO
Other
Enumeration date
08/31/2006
Last updated
09/25/2014
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