Individual
PATRICK O GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3599 UNIVERSITY BLVD S, BUILDING 300, JACKSONVILLE, FL 32216-4252
(904) 399-5550
(904) 346-4334
Mailing address
3599 UNIVERSITY BLVD S, BUILDING 300, JACKSONVILLE, FL 32216-4252
(904) 399-5550
(904) 346-4334
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME63840
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00543551A
—
GA
01
—
18678
BCBS
FL
05
—
372747500
—
FL
Enumeration date
03/27/2006
Last updated
08/21/2017
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