KENNETH B. GORDON (NPI# 1790865806) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790865806 |
| Entity Type | Individual |
| Full Name | KENNETH B. GORDON |
| Credential | M.D. |
| Practice Address |
9200 W Wisconsin Ave Department of Dermatology Milwaukee WI 53226-3522 |
| Practice Telephone | 4148053666 |
| Practice Fax Number | 4148055323 |
| Mailing Telephone | 4148053666 |
| Mailing Fax Number | 4148055323 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2017-01-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 66663 | WI | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 036086146 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1790865806 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225529043 | Kenneth Steven Gordon | Psychologist | 755 Lakefield Rd Ste J, Westlake Village, CA 91361-2639 | 2018-05-29 |
| 1154796456 | Kenneth Gordon | Pharmacist | 5261 Nw 81st Ter, Lauderhill, FL 33351-5050 | 2015-12-11 |
| 1497752208 | Kenneth Bryce Gordon | Optometrist | 4811 S Laburnum Ave, Richmond, VA 23231-2713 | 2005-07-07 |
| 1548301021 | Kenneth Lawrence Gordon | Psychiatry & Neurology | 75 Chestnut St., Oneonta, NY 13820 | 2007-02-09 |
| 1104837657 | Kenneth L. Gordon | Ophthalmology | 2080 Century Park East, #800, Los Angeles, CA 90067-2011 | 2006-08-10 |
| 1871549204 | Kenneth D Gordon | Internal Medicine | 1602 Vernon Rd, Suite 400, Lagrange, GA 30240-4100 | 2006-05-26 |
| Street Address |
9200 W WISCONSIN AVE DEPARTMENT OF DERMATOLOGY |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53226-3522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255334173 | Froedtert Memorial Lutheran Hospital, Inc. | General Acute Care Hospital | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2005-05-24 |
| 1013518182 | Shelby Koppinger | Pharmacist | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-11-05 |
| 1083215065 | Jennifer Lynn Scheffler | Physician Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-11-05 |
| 1306445952 | Elyan Carolina Ruiz Solano | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-10-23 |
| 1972101467 | Sarah Emily Ziem | Nurse Practitioner | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-10-15 |
| 1912504242 | Matthew Resop | Nurse Practitioner | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-10-09 |
| 1043817877 | Jacqueline Jordan Morgan | Nurse Practitioner | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-10-05 |
| 1134726227 | Joseph Beiler | Registered Nurse | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-10-02 |
| 1316553845 | Nathan Duncan | Pharmacist | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-09-21 |
| 1043826035 | Emily Mell | Physician Assistant | 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522 | 2020-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
| 1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
| 1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
| 1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
| Find all providers in zip 53226 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205253242 | Namita Jain | Dermatology | 3003 W Good Hope Rd Ste 1-200, Milwaukee, WI 53209-2042 | 2014-03-27 |
| 1487773206 | John Starling IIi | Dermatology | 2600 N Mayfair Rd Ste 810, Milwaukee, WI 53226-1328 | 2007-03-29 |
| 1659466779 | Milwaukee Skin Center,s.c. | Dermatology | 7400 W Brown Deer Rd, Milwaukee, WI 53223-2078 | 2006-10-04 |
| 1336179340 | Jason G. Rosenberg | Dermatology | 2350 N. Lake Drive, Suite 300, Milwaukee, WI 53211-4528 | 2006-07-04 |
| 1962453787 | Matthew G Fleming | Dermatology | 9200 West Wisconsin Avenue, Froedtert & Med College Clin - West, Milwaukee, WI 53226 | 2006-05-15 |
| 1386630861 | Dermatology Associates Sc | Dermatology | 324 E Wisconsin Ave, #925, Milwaukee, WI 53202-4300 | 2005-09-21 |
| 1912990466 | Evonne Marie Winston | Dermatology | 2315 N Lake Dr, Suite 701, Milwaukee, WI 53211-4518 | 2005-08-30 |
| 1295231769 | Michael John Knabel | Dermatology | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2018-04-03 |
| 1720510548 | Garrett N Mccoy | Dermatology | 8701 W Watertown Plank Rd, Milwaukee, WI 53226 | 2017-03-30 |
| 1669903555 | Sophia Magdeline Akhiyat | Dermatology | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2017-03-23 |
| Find all providers in MILWAUKEE | ||||
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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.