Craig J Gordon, D.O., P.C.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

SS065453 Issued in MI

Legal business name

CRAIG J GORDON, D.O., P.C.

Doing business as

Clinical Oncology Associates

Practice address

30160 Orchard Lake Rd Ste 100
Farmington Hills, MI 48334-2254

Phone

(248) 522-0222

Fax

(248) 522-0225

NPI assigned

Oct 31, 2005

Last updated

Jun 4, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Sue Hudel

Title

Practice Manager

Phone

(248) 522-0222

Specialties & licenses 2

Addresses

Other identifiers 5

Other names 1

• Clinical Oncology Associates Doing business as

Locations

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559606400000",
    "number": "1952392896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30160 ORCHARD LAKE RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342254",
            "telephone_number": "248-522-0222",
            "fax_number": "248-522-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30160 ORCHARD LAKE RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342254",
            "telephone_number": "248-522-0222",
            "fax_number": "248-522-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG J GORDON, D.O., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2019-06-04",
        "status": "A",
        "authorized_official_last_name": "HUDEL",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "248-522-0222",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "SS065453",
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "CG008584",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "OF37505",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5679150",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "P6078",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "P88665",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404140",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinical Oncology Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clinical Oncology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Hematology & Oncology Physician in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Hematology & Oncology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.