Individual
KATHLEEN P GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1524 ATWOOD AVE, SUITE 220, JOHNSTON, RI 02919
(401) 272-1900
(401) 453-3049
Mailing address
1524 ATWOOD AVE, SUITE 220, JOHNSTON, RI 02919
(401) 272-1900
(401) 453-3049
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0482
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401976
UHP
—
01
—
20540
BCRI
—
01
—
402586
BLUE CHIP RI
—
05
—
9020540
—
RI
Enumeration date
07/13/2006
Last updated
06/26/2008
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