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Individual

DR. RAMSEY D GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
21001 N TATUM BLVD, SUITE 1630-888, PHOENIX, AZ 85050-4206
(602) 788-1600
(602) 569-7001
Mailing address
21001 N TATUM BLVD, SUITE 1630-888, PHOENIX, AZ 85050-4206
(602) 788-1600
(602) 569-7001

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5212
AZ
111NR0400X
Rehabilitation Chiropractor
2937
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5212
AZ LICENCE#
AZ
01
860827817
FEDERAL TAZ ID#
AZ
01
AZ0242530
BCBS #
AZ
Enumeration date
10/05/2006
Last updated
07/19/2012
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