RONNY KEITH GORDON JR. (NPI# 1427673649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427673649 |
| Entity Type | Individual |
| Full Name | RONNY KEITH GORDON JR. |
| Practice Address |
475 Grigsby St Newcastle OK 73065-5950 |
| Practice Telephone | 4053619614 |
| Mailing Telephone | 4053619614 |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2020-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LS0200X |
Nurse Practitioner Specialization: School |
R0105864 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
475 GRIGSBY ST |
| City | NEWCASTLE |
| State | OK |
| Zip Code | 73065-5950 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346796604 | Healthcare Stat of Newcastle LLC | Nurse Practitioner | 2120 N Main St Suite B, Newcastle, OK 73065 | 2016-08-28 |
| 1871872135 | Custom Dental of Newcastle, Pllc | Dentist | 3290 N Tri-city, Newcastle, OK 73065 | 2011-08-04 |
| 1518139559 | Oca Tricity Lp | Family Medicine | 1000 Nw 32nd, Newcastle, OK 73065 | 2008-03-31 |
| 1700921798 | Senior Eye Care Service of America, LLC | Optometrist | 3385 N. Meridian, Newcastle, OK 73065 | 2007-02-20 |
| 1427113950 | Gerald Patrick Jenison | Technician, Other | 2210 S Highway 76, Newcastle, OK 73065 | 2006-12-26 |
| 1760572762 | Jim E Cox Dds PC | Dentist | 501 South Main Street, Newcastle, OK 73065 | 2006-10-13 |
| 1457325490 | Mcray- Denton Vision Center | Optometrist | 232 Bypass Road, Newcastle, OK 73065 | 2006-02-15 |
| 1790840262 | Richard Joshua Burns | Technician, Other | 2210 S Highway 76, Newcastle, OK 73065 | 2006-12-26 |
| 1982888327 | Ellison Chiropractic LLC | Chiropractor | 918 Nw 32nd St., Newcastle, OK 73065-1077 | 2007-12-20 |
| 1639352206 | Kyle John Ellison | Chiropractor | 918 N.w. 32nd Street, Suite Number 918, Newcastle, OK 73065-1077 | 2007-12-06 |
| Find all providers in zip 73065 | ||||
| Taxonomy Code | 363LS0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | School |
| Definition to come... |
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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.