Gayle Gordon, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

E-1397 Issued in AR

Practice address

2909 Military Rd
Benton, AR 72015-2721

Phone

(501) 778-4674

Fax

(501) 778-4694

NPI assigned

Jul 11, 2006

Last updated

Jul 3, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1427083310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 MILITARY RD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152721",
            "telephone_number": "501-778-4674",
            "fax_number": "501-778-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 MILITARY RD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152721",
            "telephone_number": "501-778-4674",
            "fax_number": "501-778-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "GAYLE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-1397",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-1397",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132153001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BCBS",
            "identifier": "5K572",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karla Glenn, RECOVERY ADVOCATE
• Terri J Goins
• Moranda L Golden, RECOVERY ASSISTANT
• Scott Goodrich, RECOVERY ASSISTANT
• Denise Ann Gordon, LPC
• Marrico Goree, RECOVERY ASSISTANT
• Charles Greg Gorman, QBHP
• Steve Luther Gossage
• Karleena G Gotcher, RECOVERY ASSISTANT
• Amber Grady, RECOVERY ASSISTANT

• Emergency Medicine Physician in Benton, AR
• Providers in Benton, AR by specialty
• Emergency Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.