Individual
DR. JODY LAINE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3700 KOLBE RD, LORAIN, OH 44053-1611
(440) 960-4000
Mailing address
621 S ILLINOIS AVE STE 103, MASON CITY, IA 50401-5489
(641) 428-3041
(641) 428-3059
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34.015151
OH
207R00000X
Internal Medicine Physician
DO-05472
IA
207R00000X
Internal Medicine Physician
R-11324
IA
208M00000X
Hospitalist Physician
34.015151
OH
Other
Enumeration date
04/25/2016
Last updated
11/12/2024
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