Sluis, Gordon W

Sluis, Gordon W is an individual health care provider with primary practice located at 1115 N Frontage Rd , Vicksburg MS 39180. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Sluis, Gordon W can be contacted via phone (601) 634-8790.

Contact Information

Primary practice address
1115 N Frontage Rd Vicksburg MS 39180
Phone: (601) 634-8790
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 09812 Mississippi

Profile Details

NPI number 1831127422
LBN Legal business name Sluis, Gordon W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2006
Last updated Jul 12th, 2018 - about 8 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 1831127422 NPPES
Mississippi Other 4627838 AETNA
Mississippi MEDICAID 1331287 AETNA
Mississippi MEDICAID 00013539 AETNA

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