Shawn Gorden MD PSC
Organization Active NPI Specialist · Ashland, KY
NPI 1356489652 · NPPES record last updated Jun 26, 2008
Key facts
- NPI
- 1356489652
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 39057 (KY)
- Legal business name
- SHAWN GORDEN MD PSC
- Practice address
- 617 23Rd St
Ste 6
Ashland, KY 41101-2845 - Phone
- (606) 326-0024
- Fax
- (606) 326-0041
- NPI assigned
- Feb 1, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Shawn Gorden, MD
- Title
- Pres
- Phone
- (606) 326-0024
Practitioners 3
-
Shawn R Gorden, M.D.
-
Ginger Hardy, APRN, CNM
National Provider Directory
Locations
617 23rd St
Ste 17
Ashland, KY 41101
Phone (606) 325-6888
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 39057 | KY | Yes |
Addresses
Primary practice location
617 23Rd St
Ste 6
Ashland, KY 41101-2845
Mailing address
617 23Rd St
Ste 6
Ashland, KY 41101-2845
Phone (606) 326-0024
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64091820 | Medicaid | KY |
Other providers in Ashland, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.