Gordon Kern, MD

Individual provider Active NPI Family Medicine Physician · Oswego, KS

NPI 1205976016 · NPPES record last updated Mar 26, 2019

Key facts

NPI
1205976016
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
04-28876 (KS)
Practice address
1104 Oregon Dr
Oswego, KS 67356-1826
Phone
(620) 421-2228
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-28876KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pittsburg Emergency Physicians, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-28876 KS Yes

Addresses

Primary practice location

1104 Oregon Dr
Oswego, KS 67356-1826

Mailing address

1104 Oregon Dr
Oswego, KS 67356-1826
Phone (620) 421-2228

Other providers in Oswego, KS

All providers in Oswego, KS · Family Medicine Physician in Kansas

Sources for this page

Verify at the official NPI Registry.