Individual
DR. RICHARD DOYLE GORDON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0035
Mailing address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0035
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
372333-3102
UT
163W00000X
Registered Nurse
RN60339321
WA
363LF0000X
Family Nurse Practitioner
Primary
AP61451230
WA
Other
Enumeration date
08/30/2020
Last updated
06/15/2023
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