Gordon, Lawrence W

Gordon, Lawrence W is an individual health care provider with primary practice located at 6005 Park Ave Ste 624B, Memphis TN 38119-5221. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Ophthalmology is his primary health care specialty. Gordon, Lawrence W can be contacted via phone (901) 682-1100.

Contact Information

Primary practice address
6005 Park Ave Ste 624B Memphis TN 38119-5221
Phone: (901) 682-1100
Fax: (901) 682-6915
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 19749 Tennessee
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 19749 Tennessee

Profile Details

NPI number 1982609665
LBN Legal business name Gordon, Lawrence W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Apr 26th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982609665 NPPES
Arkansas MEDICAID 146871001
Arkansas Other 5L961
Arkansas MEDICAID 0119321
Arkansas Other 5L961
Arkansas MEDICAID 3050718
Arkansas Other 180031674
Arkansas Other 3066300
Arkansas Other P00777025

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