Individual
DR. LEANNA LYN GORDON
Active
Individual
DR. LEANNA LYN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
DOS-1675
HI
208D00000X
General Practice Physician
DOS-1675
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036162996
—
IL
Enumeration date
06/11/2013
Last updated
08/22/2024
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