Individual
DR. GORDON MICHAEL TELEPUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1206 SOMERVILLE RD SE, DECATUR, AL 35601
(256) 340-5188
(256) 340-5192
Mailing address
1206 SOMERVILLE RD SE, DECATUR, AL 35601
(256) 340-5188
(256) 340-5192
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
17201
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000085141
—
AL
01
—
51085141TEL
BLUE CROSS
AL
Enumeration date
12/05/2006
Last updated
06/26/2019
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