Neil E Gordon, MD, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

22411 Issued in GA

Legal business name

NEIL E GORDON, MD, PC

Practice address

1106 N Main St
Cedartown, GA 30125-2039

Phone

(770) 748-7818

NPI assigned

Oct 23, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Neil E Gordon, MD

Title

President/Physician

Phone

(770) 748-7818

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269302400000",
    "number": "1386727394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 N MAIN ST",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252039",
            "telephone_number": "770-748-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 N MAIN ST",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252039",
            "telephone_number": "770-748-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIL E GORDON, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2010-03-23",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "770-748-7818",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "22411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000213386A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Cedartown, GA
• Providers in Cedartown, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.