PAUL ANTHONY GORDON (NPI# 1215931936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1215931936 |
Entity Type | Individual |
Full Name | PAUL ANTHONY GORDON |
Credential | M.D. |
Practice Address |
124a Professional Park Dr Conway SC 29526-9260 |
Practice Telephone | 8433479500 |
Practice Fax Number | 8433479595 |
Mailing Telephone | 8433479500 |
Mailing Fax Number | 8433479595 |
Enumeration Date | 2005-06-09 |
Last Update Date | 2010-01-07 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | 21465 | SC | Allopathic & Osteopathic Physicians |
N | 207Q00000X | Family Medicine | 9901642 | NC | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | NC BLUE CROSS BLUE SHIELD | 1244Q | 01 |
NC | 891244Q | 05 | |
SC | GP4505 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831649912 | Paul Gordon | Counselor | 3049 N 55th St, Milwaukee, WI 53210-1564 | 2016-10-12 |
1013050749 | Paul J Gordon | Chiropractor | 3441 E Causeway Appr, Suite D, Mandeville, LA 70448-3480 | 2007-02-14 |
1164510517 | Paul Richard Gordon | Dentist | 4435 Valley View Dr, Suite 103, Knoxville, TN 37917-1300 | 2006-10-11 |
1356341994 | Paul James Gordon | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10604 Southwest Hwy Ste 101, Chicago Ridge, IL 60415 | 2005-07-26 |
1679632699 | Paul Herberton Gordon | Psychiatry & Neurology | 710 W 168th St, New York, NY 10032-3726 | 2006-12-06 |
1588771893 | Paul R Gordon | Hospitalist | 707 N Alvernon Way, Suite 101, Tucson, AZ 85711-1827 | 2006-08-23 |
1215043013 | Paul H Gordon | Emergency Medicine | 1010 4th St Sw, Mason City, IA 50401-2857 | 2006-08-22 |
1164448171 | Paul E Gordon | Dentist | 77 S Bedford St Ste 100, Burlington, MA 01803-5154 | 2006-07-14 |
1568496677 | Paul C Gordon | Internal Medicine | 208 Collyer St, Ste 100, Providence, RI 02904 | 2006-07-11 |
1275560831 | Paul R. Gordon | Pediatrics | 1717 S Orange Ave Ste 100, Nemours Childrens Clinic, Orlando, Orlando, FL 32806-2946 | 2006-06-27 |
Street Address |
124A PROFESSIONAL PARK DR |
City | CONWAY |
State | SC |
Zip Code | 29526-9260 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457975237 | Terri L Champion | Massage Therapist | 172 Waccamaw Medical Park Court, Conway, SC 29526 | 2020-06-08 |
1689204398 | Alayna Defalco | Clinical Exercise Physiologist | 1320 501 Business, Unit E, Conway, SC 29526 | 2020-01-22 |
1124672662 | Proxsys Rx - Sc, LLC | Pharmacy | 300 Singelton Ridge Road, Conway, SC 29526 | 2019-08-01 |
1598227431 | Surgery Center of Conway Inc | Clinic/Center | 1405 Main Street, Conway, SC 29526 | 2019-04-01 |
1801374962 | Trevor James Hess | Specialist/Technologist | 905 One Landon Loop, Conway, SC 29526 | 2018-08-01 |
1851800817 | Katherine Ann Nimphius | Behavioral Analyst | 105 Timberline Dr, Conway, SC 29526 | 2017-09-21 |
1922544253 | William Houck | Specialist/Technologist | 925 One Landon Loop, Conway, SC 29526 | 2017-01-10 |
1952857278 | Courtney Jeanette Smith | Counselor | 164 Waccamaw Medical Park Dr., Conway, SC 29526 | 2016-08-28 |
1336502632 | Jebediah S. Christy, D.d.s - Conway, Pllc | Dentist | 2756 Church St, Conway, SC 29526 | 2016-04-04 |
1447615208 | Abl Enterprises, LLC | Optometrist | 113 Citadel Drive, Conway, SC 29526 | 2015-12-22 |
Find all providers in zip 29526 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710513957 | Conway Regional Medical Center, Inc | Family Medicine | 1700 Altus St Ste 110, Conway, AR 72032-4299 | 2020-03-19 |
1912543240 | University of Central Arkansas | Family Medicine | 201 Donaghey Ave Uca Student Health Center, Conway, AR 72035-5001 | 2019-11-21 |
1588012728 | Arkansas Health Group | Family Medicine | 625 United Dr Ste 120a, Conway, AR 72032-7826 | 2016-05-27 |
1477999282 | Michael Paul Carson | Family Medicine | 605 United Dr, Conway, AR 72032 | 2013-05-20 |
1427335835 | Brieanna R Breeding | Family Medicine | 2100 Meadowlake Rd Ste 10, Conway, AR 72032-2569 | 2011-11-14 |
1710217104 | Billy R Mcbay Md Pa | Family Medicine | 505 E Dave Ward Dr, Ste 3, Conway, AR 72032-7825 | 2010-01-06 |
1417118076 | Alexander Tyler | Family Medicine | 455 Elsinger Blvd, Conway, AR 72032-4716 | 2008-06-17 |
1336317593 | James L Floyd Jr. | Family Medicine | 128a Professional Park Place, Agape Physicians Care, Conway, SC 29526-9260 | 2008-02-11 |
1326246190 | Thad Ridge Hardin | Family Medicine | 2425 Dave Ward Dr Ste 401, Conway, AR 72034 | 2007-07-03 |
1235336959 | James Austin Capps Jr. | Family Medicine | Conway Interfaith Clinic, Inc, 830 North Creek Drive, Conway, AR 72032 | 2007-06-27 |
Find all providers in CONWAY |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.