Individual
DR. JESSICA KAYLA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
50 E HOSPITAL ST STE 3, MANNING, SC 29102-3149
(803) 435-8828
Mailing address
50 E HOSPITAL ST STE 3, MANNING, SC 29102-3149
(803) 435-8829
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LL83656
SC
207Q00000X
Family Medicine Physician
V0405
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2021
Last updated
07/12/2024
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