DR. GLENN L GORDON (NPI# 1427077213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427077213 |
| Entity Type | Individual |
| Full Name | DR. GLENN L GORDON |
| Credential | MD |
| Practice Address |
714 Medical Park Dr Mexico MO 65265-3726 |
| Practice Telephone | 5735901553 |
| Practice Fax Number | 8779587717 |
| Mailing Telephone | 5735901553 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-10-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
036067470 | IL | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
R1H39 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MISSOURI LICENSE NUMBER | R1H39 | 01 |
| MO | MEDICARE # | 0010137 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679112627 | Glenn Gordon | Physical Therapist | 341 E Moreland Rd, Willow Grove, PA 19090-3507 | 2019-12-21 |
| 1538108261 | Glenn Gordon | Emergency Medicine | 2073 Olympic St, Springfield, OR 97477 | 2006-06-06 |
| 1508850934 | Glenn E. Gordon | Dentist | 16345 Ne 87th St, Ste C-2, Redmond, WA 98052-3503 | 2005-08-31 |
| Street Address |
714 MEDICAL PARK DR |
| City | MEXICO |
| State | MO |
| Zip Code | 65265-3726 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922356765 | Hannibal Regional Hospital | Internal Medicine | 714 Medical Park Dr, Mexico, MO 65265-3726 | 2012-08-28 |
| 1114102654 | Center for Digestive & Liver Diseases, Inc. | Internal Medicine | 714 Medical Park Dr, Mexico, MO 65265-3726 | 2008-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700448685 | Joanna Zidick Mcclarey | Specialist/Technologist | Rehabilitation Services, 711 E Jackson, Mexico, MO 65265 | 2019-07-01 |
| 1053858050 | Glenna Wilson | Social Worker | 2462 Southern Hls, Mexico, MO 65265 | 2017-01-27 |
| 1457601759 | Bruce Warren Garrett | Dentist | 626 Summit, Mexico, MO 65265 | 2012-09-13 |
| 1063775997 | Brandon Jay Glasgow | Physical Therapist | 2759 A S Clark, Mexico, MO 65265 | 2012-06-15 |
| 1407044548 | Missouri Central Physical Therapy, LLC | Specialist | 2759 A South Clark, Mexico, MO 65265 | 2007-10-12 |
| 1194925628 | Curators of The University of Missouri | Orthopaedic Surgery | 515 East Promenade, Mexico, MO 65265 | 2007-07-23 |
| 1740496199 | Scott Simmons | Family Medicine | 1000 Webster Street, Mexico, MO 65265 | 2007-05-15 |
| 1083741664 | Finck & Associates, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17079 Audrain County Road 929, Mexico, MO 65265 | 2007-02-28 |
| 1417005893 | Matthew Eugene Hart | Emergency Medicine | 620 E Monroe Street, Mexico, MO 65265 | 2007-01-08 |
| 1144392051 | Corrine M Floyd | Massage Therapist | 713 East Jackson, Mexico, MO 65265 | 2006-11-15 |
| Find all providers in zip 65265 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922356765 | Hannibal Regional Hospital | Internal Medicine | 714 Medical Park Dr, Mexico, MO 65265-3726 | 2012-08-28 |
| 1114102654 | Center for Digestive & Liver Diseases, Inc. | Internal Medicine | 714 Medical Park Dr, Mexico, MO 65265-3726 | 2008-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316589708 | Gastroenterology of The Four States,llc | Internal Medicine | 2024 S Maiden Ln Ste 204, Joplin, MO 64804-0319 | 2019-10-17 |
| 1013414317 | Digestive Consultants LLC | Internal Medicine | 222 S Woods Mill Rd Ste 410, Chesterfield, MO 63017 | 2018-04-12 |
| 1184038788 | Prianka Radhika Chilukuri | Internal Medicine | 3635 Vista Avenue, Fdt 9 South, St. Louis, MO 63110 | 2014-06-12 |
| 1871911149 | Sean Doran | Internal Medicine | 2521 Glenn Hendren Dr Ste 408, Liberty, MO 64068-3388 | 2014-04-02 |
| 1215359484 | Advanced Gastroenterology & Colon Cancer Screening Center LLC | Internal Medicine | 763 S New Ballas Rd # 265, Saint Louis, MO 63141-8704 | 2014-01-07 |
| 1689014276 | Antonio Ricardo Cheesman Rocca | Internal Medicine | 1225 S Grand Blvd Fl 3, Saint Louis, MO 63104-1016 | 2013-06-27 |
| 1578805610 | Paul Edmond St. Romain | Internal Medicine | 2115 S Fremont Ave Ste 3300, Springfield, MO 65804-2246 | 2013-03-26 |
| 1114285947 | Samuel Wieland Schowengerdt | Internal Medicine | 5330 N Oak Trfy Ste 102, Kansas City, MO 64118 | 2012-04-30 |
| 1720346729 | Kayci Renee Huff-hardy | Internal Medicine | 621 S New Ballas Rd Ste 437a, Saint Louis, MO 63141-8259 | 2012-04-26 |
| 1649542713 | Robert Earl Stufflebam | Internal Medicine | 3895 E Pond Apple Dr, Springfield, MO 65809-3752 | 2012-02-03 |
| Find all providers with the same taxonomy | ||||
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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.