Gordon, Timothy Eugene
Gordon, Timothy Eugene is an sole proprietor health care provider with primary practice located at 5701 Herrera Dr , Santa Fe NM 87507-2677. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gordon, Timothy Eugene can be contacted via phone (505) 424-9139.Contact Information
Primary practice address
5701 Herrera Dr
Santa Fe NM 87507-2677
Phone: (505) 424-9139
Fax: (505) 424-1384
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2274 | New Mexico |
Profile Details
| NPI number | 1053324988 |
|---|---|
| LBN Legal business name | Gordon, Timothy Eugene |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 14th, 2006 |
| Last updated | Sep 27th, 2013 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053324988 | NPPES |
| New Mexico | MEDICAID | 000P4328 |
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