Individual
MR. JOHN MICHAEL GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
311A RADIO PARK DR, RICHMOND, KY 40475
(859) 624-2010
(859) 625-1229
Mailing address
311 A RADIO PARK DR, RICHMOND, KY 40475
(859) 624-2010
(859) 625-1229
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
16823
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64168230
—
KY
Enumeration date
08/29/2006
Last updated
07/08/2007
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