Michael C. Gordon, Md, Llc in Smyrna - Addiction Medicine
Michael C. Gordon, Md, Llc - NPI 1598957011
Michael C. Gordon, Md, Llc is a Addiction Medicine in Smyrna, Georgia. Michael C. Gordon, Md, Llc practices all healthcare services and medical treatments related to Addiction Medicine. The NPI Number for Michael C. Gordon, Md, Llc is 1598957011. The last update date is 2007-08-17.
Michael C. Gordon, Md, Llc's current location address is 4015 S Cobb Dr Se, Smyrna, Georgia. You can contact this provider via phone number 7708010980 and fax number 7708019039. The mailing address for Michael C. Gordon, Md, Llc is 4015 S Cobb Dr Se, Smyrna, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Michael C. Gordon, Md, Llc |
|---|---|
| Address | 4015 S Cobb Dr Se, Smyrna, Georgia |
| Phone Number | 7708010980 |
| Fax Number | 7708019039 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Gordon C Michael |
| Credentials | MD |
| Telephone Number | 7708010980 |
NPI Number Detail
| NPI Number | 1598957011 |
|---|---|
| Provider Enumeration Date | 2007-08-17 |
| Last Updated Date | 2007-08-17 |
Provider Mailing Address Detail
| Address | 4015 S Cobb Dr Se |
|---|---|
| City | Smyrna |
| State | Georgia (GA) |
| Post Code | 300806303 |
| Phone Number | 7708010980 |
| Fax Number | 7708019039 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction Medicine |
|---|---|
| Taxonomy | 2084A0401X |
| Licence No | 26534 |
|
Definition: A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 461679 | GA | BLUE CROSS BLUE SHIELD |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Michael C. Gordon, Md, Llc by the Centers for Medicare & Medicaid Services?
The Michael C. Gordon, Md, Llc has been issued the NPI (National Provider Identifier) 1598957011 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Michael C. Gordon, Md, Llc located?
The Michael C. Gordon, Md, Llc is located at 4015 S Cobb Dr Se, Smyrna, GA 300806303.
What is Michael C. Gordon, Md, Llc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Michael C. Gordon, Md, Llc's specialized field of practice is Addiction Medicine, and the corresponding taxonomy code that categorizes this area of specialization is 2084A0401X.
On what date did the Centers for Medicare & Medicaid Services issue the 1598957011 to Michael C. Gordon, Md, Llc?
The Michael C. Gordon, Md, Llc received its 1598957011 assignment from the Centers for Medicare & Medicaid Services on 2007-08-17.
As of what date were the details related to Michael C. Gordon, Md, Llc most recently updated or revised?
The information pertaining to Michael C. Gordon, Md, Llc, including its address, specialty, and other relevant details, was last updated or revised on 2007-08-17.