Gordon, Randy Paul

Gordon, Randy Paul is an individual health care provider with primary practice located at 520 S Mustang Rd , Yukon OK 73099-6737. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Gordon, Randy Paul can be contacted via phone (405) 749-7099.

Contact Information

Primary practice address
520 S Mustang Rd Yukon OK 73099-6737
Phone: (405) 749-7099
Fax: (405) 577-2032
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1585 Oklahoma

Profile Details

NPI number 1487705711
LBN Legal business name Gordon, Randy Paul
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2007
Last updated Feb 18th, 2016 - about 10 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 1487705711 NPPES
Oklahoma MEDICAID 200102980A

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