Charles R Gordon Md Pa in Tyler - Nurse Practitioner
Charles R Gordon Md Pa - NPI 1982717955
Charles R Gordon Md Pa is a Nurse Practitioner in Tyler, Texas. Charles R Gordon Md Pa practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Charles R Gordon Md Pa is 1982717955. The last update date is 2020-03-10.
Charles R Gordon Md Pa's current location address is Po Box 6605, Tyler, Texas. You can contact this provider via phone number 9035926000 and fax number 9035951592. The mailing address for Charles R Gordon Md Pa is Po Box 6605, Tyler, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Charles R Gordon Md Pa |
|---|---|
| Address | Po Box 6605, Tyler, Texas |
| Phone Number | 9035926000 |
| Fax Number | 9035951592 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Gordon R Charles |
| Credentials | M.D. |
| Telephone Number | 9035926000 |
NPI Number Detail
| NPI Number | 1982717955 |
|---|---|
| Provider Enumeration Date | 2006-08-16 |
| Last Updated Date | 2020-03-10 |
Provider Mailing Address Detail
| Address | Po Box 6605 |
|---|---|
| City | Tyler |
| State | Texas (TX) |
| Post Code | 757116605 |
| Phone Number | 9035926000 |
| Fax Number | 9035951592 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
|
Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 163108701 | TX | -- | |
| 0023KV | BLUE CROSS BLUE SHIELD |
Post Comment/ Review Below
What is the unique identifier code issued to Charles R Gordon Md Pa by the Centers for Medicare & Medicaid Services?
The Charles R Gordon Md Pa has been assigned the NPI (National Provider Identifier) 1982717955. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Charles R Gordon Md Pa's facilities are situated?
The facilities of Charles R Gordon Md Pa are physically located at the following address: Po Box 6605, Tyler, TX, 757116605.
What is Charles R Gordon Md Pa's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Charles R Gordon Md Pa is Nurse Practitioner, and the corresponding taxonomy classification code for this specialized field is 363L00000X.
On what date did the Charles R Gordon Md Pa receive the assignment of its 1982717955 from the Centers for Medicare & Medicaid Services?
The Charles R Gordon Md Pa was issued its 1982717955 by the Centers for Medicare & Medicaid Services on 2006-08-16.
As of what date were the details pertaining to Charles R Gordon Md Pa last refreshed?
The information related to the Charles R Gordon Md Pa, including its address, specialty, and other relevant details, was last updated on 2020-03-10.
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