DR. ZACHARY NATHAN GORDON (NPI# 1790075851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790075851 |
| Entity Type | Individual |
| Full Name | DR. ZACHARY NATHAN GORDON |
| Credential | M.D. |
| Practice Address |
2705 N Lebanon St Ste 265 Lebanon IN 46052 |
| Mailing Address |
2705 N Lebanon St Ste 305 Lebanon IN 46052-8622 |
| Practice Telephone | 7654858730 |
| Practice Fax Number | 7654858739 |
| Mailing Telephone | 7654858852 |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2019-08-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208800000X | Urology | 70116-20 | WI | Allopathic & Osteopathic Physicians |
| Y | 208800000X | Urology | 01077056A | IN | Allopathic & Osteopathic Physicians |
| N | 2083C0008X |
Preventive Medicine Specialization: Clinical Informatics |
01077056A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201369920 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 N Oak Ave, Marshfield, WI 54449 | 7153875231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306406889 | Zachary Gordon | Occupational Therapy Assistant | 120 W 97th St Apt 5e, New York, NY 10025-9223 | 2019-06-18 |
| 1669956785 | Zachary Gordon | Social Worker | 4905 Del Ray Ave, Bethesda, MD 20814-2527 | 2018-09-25 |
| 1043767551 | Zachary Gordon | Physical Therapist | 101 University Dr, Suite A-6, Amherst, MA 01002-2473 | 2016-09-01 |
| 1396919262 | Zachary M. Gordon | Anesthesiology | 3626 Ruffin Rd, San Diego, CA 92123-1810 | 2008-04-22 |
| 1770771941 | Zachary L Gordon | Orthopaedic Surgery | 11100 Euclid Ave, Dept of Orthopaedic Surgery, Cleveland, OH 44106-1716 | 2007-10-11 |
| Street Address |
2705 N LEBANON ST STE 265 |
| City | LEBANON |
| State | IN |
| Zip Code | 46052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588661409 | Mark J Janicki | Psychiatry & Neurology | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2005-07-07 |
| 1225324841 | Amanda Jean Stevens-udeze | Internal Medicine | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2011-06-22 |
| 1306167424 | Chad H Meshberger | Psychiatry & Neurology | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2010-06-14 |
| 1376869669 | Kevin Boone | Hospitalist | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2010-04-13 |
| 1598995086 | Adam Anthony Cieciuch | Internal Medicine | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2009-07-20 |
| 1396905782 | Tehniat Haider | Internal Medicine | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2008-06-10 |
| 1528226321 | Neha Shardul Gavin | Internal Medicine | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2008-05-28 |
| 1922169374 | Alex Kor | Podiatrist | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2006-12-12 |
| 1356307003 | Crystal L Jones | Internal Medicine | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2006-04-21 |
| 1740277466 | Thomas Ray Cartwright | Internal Medicine | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2005-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316567647 | Meredith England Labrie | Behavioral Analyst | 110 Birchwood Drivve, Lebanon, IN 46052 | 2020-04-16 |
| 1710401492 | Kenzlie Ann Westerfield | Specialist/Technologist | 613 Countryside Drive, Lebanon, IN 46052 | 2017-08-03 |
| 1487040044 | Jenny L Essex | Social Worker | 1614 N. Lebanon St., Integrative Wellness, LLC, Lebanon, IN 46052 | 2015-04-10 |
| 1316177363 | Kathryn Elizabeth Ehrgott | Counselor | 1005 South Lebanon Street, Boone County Services, Lebanon, IN 46052 | 2009-07-23 |
| 1780838557 | Kathleen M Whitaker | Registered Nurse | 209 W North St, Lebanon, IN 46052 | 2008-11-06 |
| 1851551998 | James R Mcafee | General Practice | 1997 Terrace Ln, Lebanon, IN 46052 | 2008-06-12 |
| 1518021773 | Zulfiqar Ali Mirza | Internal Medicine | 2505 N Lebanon St Ste 220, Lebanon, IN 46052 | 2006-12-21 |
| 1316016108 | Russell Allen Lindner | Chiropractor | 3920 North State Road 39, Boone County Chiropractic Office, Lebanon, IN 46052 | 2006-11-07 |
| 1487755781 | Cowan Drugs Inc | Pharmacy | 112 N Lebanon St, Lebanon, IN 46052 | 2006-09-26 |
| 1558463992 | Cowan Drugs Inc | Pharmacy | 1639 N Lebanon St, Lebanon, IN 46052 | 2006-09-05 |
| Find all providers in zip 46052 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104187632 | Jay Edmund Sulek | Urology | 1420 W Baddour Pkwy Ste 100, Lebanon, TN 37087 | 2012-05-31 |
| 1871818880 | Daniel Lee | Urology | 735 Norman Dr Ste B, Lebanon, PA 17042-7559 | 2010-04-01 |
| 1184686107 | Madhukar R Patel | Urology | 815 Norman Dr, Lebanon, PA 17042-7445 | 2006-04-05 |
| 1902308331 | Lancaster Urology | Urology | 1510 Cornwall Rd, Lebanon, PA 17042-7479 | 2018-03-01 |
| 1235655952 | Urology Associates PC | Urology | 1420 W Baddour Pkwy Ste 100, Lebanon, TN 37087-1510 | 2017-08-15 |
| 1558749846 | Good Samaritan Physician Services | Urology | 735 Norman Dr, Suite B, Lebanon, PA 17042-7497 | 2015-05-07 |
| 1003293887 | Gina Nicole Tundo | Urology | 1 Medical Center Dr, Dhmc, Lebanon, NH 03756-1000 | 2015-04-30 |
| 1578901195 | Michael Thomas Grant | Urology | One Medical Center Drive, Dartmouth Hitchcock - Urology, Lebanon, NH 03756-1000 | 2013-06-05 |
| 1033459854 | Spring View Physician Practice, LLC | Urology | 420 Loretto Rd, Suite 600, Lebanon, KY 40033-1628 | 2013-02-15 |
| 1174862304 | Mid-valley Healthcare, Inc. | Urology | 100 Mullins Dr, Suite D-3, Lebanon, OR 97355-2868 | 2013-02-07 |
| Find all providers in LEBANON | ||||
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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.