Individual
JASON GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3950 AUSTELL RD, AUSTELL, GA 30106-1121
(770) 732-3800
Mailing address
5665 NEW NORTHSIDE DR NW, SUITE 320, ATLANTA, GA 30328-5831
(770) 874-5400
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
PENDING
GA
Other
Enumeration date
05/22/2008
Last updated
05/22/2008
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