Individual
DR. TRACY A GORDON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1205 S TELSHOR BLVD, LAS CRUCES, NM 88011-4748
(505) 260-4300
(505) 260-4338
Mailing address
1720 LOUISIANA BLVD NE, STE 401, ALBUQUERQUE, NM 87110-7020
(505) 260-4300
(505) 260-4338
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
97-63
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM009V08
BLUE CROSS BLUE SHIELD
NM
05
—
Q0054
—
NM
Enumeration date
06/09/2005
Last updated
07/09/2007
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