Individual
CHRISTOPHER R. GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1157 N 300 W, PROVO, UT 84604-6124
(801) 357-1200
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 357-1200
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
8233708-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/06/2009
Last updated
09/30/2021
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