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Individual

DR. FRANK V GORDON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
308 S 5TH ST, GRIFFIN, GA 30224-4344
(770) 229-1150
Mailing address
320 RAMPART ST, MCDONOUGH, GA 30253-6484
(770) 229-1150
(770) 229-1150

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
P0000001857
TN
103T00000X
Psychologist
Primary
PSY001858
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10032590
AMERIGROUP
GA
Enumeration date
04/02/2007
Last updated
07/09/2007
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