Individual
B. GORDON CARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
BLD 301 ANDREWS AVE, FORT RUCKER, AL 36362-5333
(334) 255-7363
(334) 255-7368
Mailing address
BLD 301 ANDREWS AVE, FORT RUCKER, AL 36362-5333
(334) 255-7363
(334) 255-7368
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28806
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64255557
—
KY
Enumeration date
05/26/2006
Last updated
11/07/2012
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