Individual
DR. GORDON EARL BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.,M.D.
Contact information
Practice address
2700 SE STRATUS AVE, SUITE 304, MCMINNVILLE, OR 97128-6255
(503) 434-6090
(503) 474-3306
Mailing address
2700 SE STRATUS AVE, SUITE 304, MCMINNVILLE, OR 97128-6255
(503) 434-6090
(503) 474-3306
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD21516
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130022916
RAILROAD MEDICARE
OR
05
—
134029
—
OR
01
—
603273000
US DEPARTMENT OF LABOR
OR
Enumeration date
06/24/2006
Last updated
12/16/2011
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