Individual
DR. GORDON CARL SHIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4301 W MARKHAM ST # 543, LITTLE ROCK, AR 72205-7101
(501) 686-8000
Mailing address
4301 W MARKHAM ST # 543, LITTLE ROCK, AR 72205-7101
(501) 686-8000
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
R-2531
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107655001
—
AR
01
—
14676000000
QUAL CHOICE
AR
01
—
328824
WELLCARE
GA
05
—
883134750A
—
GA
Enumeration date
12/28/2006
Last updated
07/17/2008
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