Individual
DR. ZACHARY NATHAN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2705 N LEBANON ST STE 265, LEBANON, IN 46052
(765) 485-8730
(765) 485-8739
Mailing address
2605 N LEBANON ST, LEBANON, IN 46052-1476
Taxonomy
Speciality
Code
Description
License number
State
2083C0008X
Clinical Informatics Physician
01077056A
IN
208800000X
Urology Physician
Primary
01077056A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201369920
—
IN
Enumeration date
04/11/2011
Last updated
10/11/2023
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