Gordon, Robert L

Gordon, Robert L is an sole proprietor health care provider with primary practice located at 5174 Blazer Parkway , Dublin OH 43017. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Gordon, Robert L can be contacted via phone (614) 792-9104.

Contact Information

Primary practice address
5174 Blazer Parkway Dublin OH 43017
Phone: (614) 792-9104
Fax: (614) 792-2382
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 4346 Ohio

Profile Details

NPI number 1679626923
LBN Legal business name Gordon, Robert L
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 19th, 2007
Last updated Mar 8th, 2012 - about 13 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 1679626923 NPPES
Other 113095 MHN
Other 0026591 MHN
MEDICAID 0815523 MHN
Other 542647 MHN
Other 000000119574 MHN

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