Individual
DR. JEFFERY S GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 SAWGRASS CORPORATE PARKWAY, STE 200, SUNRISE, FL 33323-2823
(800) 243-3839
(855) 527-5510
Mailing address
127 CRESTVIEW PARK DR, DICKSON, TN 37055-2855
(615) 446-5121
(615) 446-1357
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD11542
TN
208M00000X
Hospitalist Physician
Primary
11542
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3179587
—
TN
01
—
370017664
RAILROAD MEDICARE PIN
—
01
—
4057650
BLUE CROSS BLUE SHIELD TN
TN
Enumeration date
05/23/2005
Last updated
12/16/2016
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