Gordon, Scott David

Gordon, Scott David is an individual health care provider with primary practice located at 225 E Lee Ave , Yadkinville NC 27055. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gordon, Scott David can be contacted via phone (336) 679-2931.

Contact Information

Primary practice address
225 E Lee Ave Yadkinville NC 27055
Phone: (336) 679-2931
Fax: (336) 677-6486
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1999 North Carolina

Profile Details

NPI number 1598723934
LBN Legal business name Gordon, Scott David
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Mar 7th, 2023 - about 3 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 1598723934 NPPES
Other 2474038C MEDICARE - YADKINVILLE
Other 525320 MEDICARE - YADKINVILLE
Other 1598723934 MEDICARE - YADKINVILLE
Other 1999 MEDICARE - YADKINVILLE
Other 2474038D MEDICARE - YADKINVILLE
MEDICAID 5908096 MEDICARE - YADKINVILLE

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