Individual
MS. TARA ANN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
107 E OAK AVE, FLAGSTAFF, AZ 86001-1818
(928) 779-7880
(928) 779-7895
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3598
AZ
Other
Enumeration date
01/12/2007
Last updated
05/06/2021
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