DR. GARY G. GORDON (NPI# 1124010640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124010640 |
| Entity Type | Individual |
| Full Name | DR. GARY G. GORDON |
| Credential | D.O. |
| Practice Address |
1800 12th St Meridian MS 39301-4158 |
| Practice Telephone | 6017039265 |
| Practice Fax Number | 6017039401 |
| Mailing Telephone | 6017039265 |
| Mailing Fax Number | 6017039936 |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2013-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
07448 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | MEDICAID OF AL | 000039981 | 01 |
| MS | 04458061 | 05 | |
| AL | BLUE CROSS OF AL | 73003105 | 01 |
| MS | UNITED HEALTH CARE | 0130017 | 01 |
| RAILROAD MEDICARE | 080030813 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811280605 | Gary N Gordon | Dentist | 5100 Tamiami Trl N, Suite 201, Naples, FL 34103-2824 | 2011-05-26 |
| 1689675449 | Gary M Gordon | Podiatrist | 2285 Cross Rd, Glenside, PA 19038-5023 | 2005-08-02 |
| 1952431629 | Gary Lee Gordon | Social Worker | 6800 Backlick Rd, Suite 202, Springfield, VA 22150-3070 | 2007-03-06 |
| 1124177167 | Gary Hart Gordon | Radiology | 10810 Connecticut Ave, Kaiser Permanente Kensington Medical Center, Kensington, MD 20895-2138 | 2007-01-09 |
| 1225065774 | Gary Gordon | Internal Medicine | 100 E Lancaster Ave, Suite 137 Lankenau Medical Bldg., Wynnewood, PA 19096-3450 | 2006-06-27 |
| 1245291780 | Gary S Gordon | Internal Medicine | 800 Biesterfield Rd, Suite 210, Elk Grove Village, IL 60007-3311 | 2006-03-31 |
| Street Address |
1800 12TH ST |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39301-4158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710986591 | Richard S. Abney | Internal Medicine | 1800 12th St, Meridian, MS 39301-4158 | 2005-07-14 |
| 1962057950 | Charles D Lafleur | Nurse Practitioner | 1800 12th St, Meridian, MS 39301-4158 | 2019-08-06 |
| 1255806329 | Delois Darlene Ortego | Nurse Practitioner | 1800 12th St, Meridian, MS 39301-4158 | 2018-10-04 |
| 1003334301 | Amanda Danielle Simpson | Nurse Practitioner | 1800 12th St, Meridian, MS 39301-4158 | 2017-09-07 |
| 1689119851 | Medical Arts Surgical Group | Surgery | 1800 12th St, Meridian, MS 39301-4158 | 2016-12-27 |
| 1053866681 | Alisha L Miller | Nurse Practitioner | 1800 12th St, Meridian, MS 39301-4158 | 2016-08-24 |
| 1356791982 | Trenton Hughes | Nurse Practitioner | 1800 12th St, Meridian, MS 39301-4158 | 2016-06-14 |
| 1588037972 | Kristen Mcpherson | Nurse Practitioner | 1800 12th St, Meridian, MS 39301 | 2015-11-05 |
| 1275910663 | Rush Medical Foundation | Family Medicine | 1800 12th St, Meridian, MS 39301-4158 | 2015-05-05 |
| 1801294772 | Donald Jason Farrar | Family Medicine | 1800 12th St, Meridian, MS 39301-4158 | 2014-12-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407460439 | Kayla Lee Monsour | Pharmacist | 1415 24th Avenue, Meridian, MS 39301 | 2020-09-08 |
| 1306478359 | K&r Optical Solutions Corporation | Eyewear Supplier (Equipment, not the service) | 3126 8th St., Suite A, Meridian, MS 39301 | 2020-02-07 |
| 1912537317 | Courtney M Hollie | Counselor | 1054 Ms-19, Meridian, MS 39301 | 2020-01-24 |
| 1932636495 | Rcg Mississippi, Inc. | Clinic/Center | 1300 38th Ave E, Meridian, MS 39301 | 2017-05-16 |
| 1811428915 | Tierria Mcglothin | Nurse Practitioner | 1054 Highway 19 S, Meridian, MS 39301 | 2017-03-21 |
| 1154869303 | Lindsay Nemanich | Physical Therapist | 3716 Ms-39, Meridian, MS 39301 | 2017-02-08 |
| 1700323599 | Wal-mart Stores East Lp | Pharmacy | 3310-a Highway 39 North, Meridian, MS 39301 | 2017-01-31 |
| 1972977460 | Southeast Pharmacy LLC | Pharmacy | 2402 Long Creek Road, Meridian, MS 39301 | 2015-11-20 |
| 1235508342 | East Mississippi Oral & Facial Surgery, LLC | Clinic/Center | 1212 24th Avenue, Meridian, MS 39301 | 2015-09-18 |
| 1831580778 | Clarkdale Pharmacy and Gifts LLC | Pharmacy | 6935c Hwy 145, Meridian, MS 39301 | 2015-02-13 |
| Find all providers in zip 39301 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1104395565 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 4800 Lakeland Drive, Flowood, MS 39232 | 2018-11-15 |
| 1467921825 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 2781 C T Switzer Sr Drive, Suite 308, Biloxi, MS 39531 | 2018-11-15 |
| 1295224954 | Flora Physicians, Pllc | Family Medicine | 4848 Main St, Flora, MS 39071-9515 | 2018-05-08 |
| 1265803985 | Mississippi Phs Md LLC | Family Medicine | 232 Market St, Flowood, MS 39232-3339 | 2015-10-08 |
| 1609187152 | Rebecca E Hollingsworth | Family Medicine | 20 Rawls Springs Loop Rd, Hattiesburg, MS 39402-7801 | 2010-06-30 |
| 1104076645 | Ashley Wayne Harris | Family Medicine | 845 S Madison St, Tupelo, MS 38801-4905 | 2008-09-20 |
| 1255447900 | Donald D. Weaver | Family Medicine | 1612 31st Ave, Gulfport, MS 39501-2750 | 2006-08-22 |
| 1659388585 | John Phenis Hey IIi | Family Medicine | 405 River Rd, Greenwood, MS 38930-4212 | 2006-08-02 |
| 1841206760 | Robert H Pierce | Family Medicine | 400 Veterans Ave, Biloxi, MS 39531-2410 | 2006-07-31 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.