Individual
GORDON W AIR
Active
Individual
GORDON W AIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
15743
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000249588
ANTHEM
KY
01
—
0428850004
MEDICARE DME
KY
05
—
64157431
—
KY
01
—
90008962
MEDICAID DME
KY
01
—
CB8861
RAILROAD MEDICARE
KY
Enumeration date
06/01/2005
Last updated
03/25/2008
Update your record
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