Westside Dermatology Associates A Professional Medical Corporation

NPI 1588725808 - Specialist - 174400000X

NPI Details
NPI 1588725808
Enumeration Date 12/12/2006
Last Updated 03/04/2010
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name GORDON J GORDON
Position PHYSICIAN
Phone (504) 391-7525
Fax (504) 391-7624
Practice Location
120 MEADOWCREST ST
SUITE 160
GRETNA LA, 70056-5255, US
Phone (504) 391-7525
Fax (504) 391-7624
Business Location
120 MEADOWCREST ST
SUITE 160
GRETNA LA, 70056-5255, US
Phone (504) 391-7525
Fax (504) 391-7624
Toxanomy
Taxonomy Code 174400000X
License State Louisiana
License Number 015208
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According to our database, Westside Dermatology Associates A Professional Medical Corporation NPI is 1588725808, taxonomy code is 174400000X and license number is 015208, license state is located at Louisiana. Westside Dermatology Associates A Professional Medical Corporation physically located at 120 Meadowcrest St, Gretna LA, 70056-5255. NPI Number 1033115704 has the healthcare provider type.

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1588725808 NPI number is provided on an as is basis without warranty of any kind. 1588725808 is maintained by the National Plan & Provider Enumeration System. The contents of Westside Dermatology Associates A Professional Medical Corporation are for informational purposes only.