Gordon, Wade Travis

Gordon, Wade Travis is an individual health care provider with primary practice located at 1 Guthrie Sq , Sayre PA 18840-1625. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Gordon, Wade Travis can be contacted via phone (570) 887-2841.

Contact Information

Primary practice address
1 Guthrie Sq Sayre PA 18840-1625
Phone: (570) 887-2841
Fax: (570) 887-2364
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X MD469347 Pennsylvania
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 221155 New York

Profile Details

NPI number 1316936842
LBN Legal business name Gordon, Wade Travis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Mar 15th, 2021 - about 4 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 1316936842 NPPES
New York Other 221155 STATE MEDICAL LICENSE

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