DR. CHARLES MARVIN GORDON JR. (NPI# 1275825135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275825135 |
Entity Type | Individual |
Full Name | DR. CHARLES MARVIN GORDON JR. |
Credential | M.D. |
Practice Address |
1505 Daphne Ave Daphne AL 36526 |
Mailing Address |
1505 Daphne Ave Daphne AL 36526-4298 |
Practice Telephone | 2516252663 |
Mailing Telephone | 2516252663 |
Enumeration Date | 2011-05-11 |
Last Update Date | 2018-08-01 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
MD36872 | AL | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Address | Telephone Number | Fax Number |
---|---|---|
5 Mobile Infirmary Cir, Mobile, AL 366073513 | 2516252663 | |
750 Morphy Ave, Fairhope, AL 365321812 | 2516252663 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942692769 | Charles Gordon | Physical Therapist | 29 Center St Ste 1, Goffstown, NH 03045-2948 | 2015-03-03 |
1811019268 | Charles Thomas Gordon IIi | Psychiatry & Neurology | 11204 Farmland Dr, Rockville, MD 20852-4522 | 2007-04-05 |
1821103631 | Charles Albert Gordon | Physical Medicine & Rehabilitation | 1059 S Fairfax Ave, Los Angeles, CA 90019-4402 | 2006-08-20 |
1831164722 | Charles G. Gordon | Dentist | 1026 Eagleridge Blvd, Pueblo, CO 81008-2130 | 2006-02-22 |
1649243890 | Charles F Gordon | Anesthesiology | 9 Old Plank Rd Ste 100, Clifton Park, NY 12065-3107 | 2006-02-08 |
1326049529 | Charles Richard Gordon | Family Medicine | 200 Cabrini Blvd, Suite 17, New York, NY 10033-1100 | 2005-08-10 |
1750858700 | Charles Gordon | Case Manager/Care Coordinator | 4269 Pearl Rd, Cleveland, OH 44109-4234 | 2018-10-29 |
1134642655 | Charles Gordon | Nurse Anesthetist, Certified Registered | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2017-07-18 |
1114382025 | Charles Gordon Jr. | Physician Assistant | 315 S Manning Blvd, Albany, NY 12208-1707 | 2015-12-18 |
1841405743 | Charles Robert Gordon | Specialist/Technologist | 3910 Teays Valley Rd, Hurricane, WV 25526-9756 | 2007-05-14 |
Street Address |
1505 DAPHNE AVE |
City | DAPHNE |
State | AL |
Zip Code | 36526 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710973490 | Paul B Canale | Specialist | 1505 Daphne Ave, Daphne, AL 36526-4298 | 2005-09-27 |
1497365324 | Hannah Clair Dunn | Physician Assistant | 1505 Daphne Ave, Daphne, AL 36526-4298 | 2020-08-05 |
1477170272 | Kaleigh Hornberger | Nurse Practitioner | 1505 Daphne Ave, Daphne, AL 36526-4298 | 2020-06-29 |
1487102810 | Holly Scott | Nurse Practitioner | 1505 Daphne Ave, Daphne, AL 36526-4298 | 2016-09-14 |
1972953081 | Seneca Walden | Nurse Practitioner | 1505 Daphne Ave, Daphne, AL 36526-4298 | 2016-06-20 |
1285009282 | Roderick Gibbs | Massage Therapist | 1505 Daphne Ave, Daphne, AL 36526-4298 | 2015-12-02 |
1154739548 | Elizabeth Hill Luscher | Nurse Practitioner | 1505 Daphne Ave, Daphne, AL 36526-4298 | 2014-07-29 |
1336441500 | Shireen S Knowles | Nurse Practitioner | 1505 Daphne Ave, Daphne, AL 36526-4298 | 2010-11-22 |
1205087558 | Dawn F Thomas | Physical Therapist | 1505 Daphne Ave, Daphne, AL 36526-4298 | 2008-10-06 |
1417166166 | Matthew Goldman | Specialist | 1505 Daphne Ave, Daphne, AL 36526-4298 | 2007-05-21 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578173464 | H3o Living, LLC | Clinic/Center | 29000 U.S. 98, Daphne, AL 36526 | 2020-08-05 |
1790345403 | Gregory Conner Reese | Student in an Organized Health Care Education/Training Program | 27654 Red Eagle Drive, Daphne, AL 36526 | 2019-06-14 |
1649787912 | Jubilee Family Dentistry, LLC | Dentist | 6475 Jordan Avenue, Daphne, AL 36526 | 2018-01-08 |
1770090607 | Gary Andrew Gould | Physician Assistant | 28490 2nd St Ste B, Daphne, AL 36526 | 2017-12-31 |
1366957011 | Emily Jane Tisdale | Behavioral Analyst | 1203 Us Highway 98 Ste 2a9, Daphne, AL 36526 | 2017-12-04 |
1437680600 | Blair Hoffman Pringle | Nurse Practitioner | 26179 Capitol Drive Suite A, Daphne, AL 36526 | 2017-03-21 |
1275915324 | Simara Sokom | Pharmacist | 29487 State Highway 181, Daphne, AL 36526 | 2015-06-25 |
1366859126 | Seth Matthew Gross | Pharmacist | 101b Villa Drive, Suite B-260, Daphne, AL 36526 | 2014-07-14 |
1841627940 | Michelle Renae Counts | Counselor | 9086 Merritt Road Suite C, Williamsburg Plaza, Daphne, AL 36526 | 2013-10-03 |
1194066613 | Ryan Nobles | Chiropractor | 6483 Van Buren Street, Suite 101, Daphne, AL 36526 | 2013-03-07 |
Find all providers in zip 36526 |
Taxonomy Code | 207XS0117X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
Specialization | Orthopaedic Surgery of the Spine |
Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639710882 | Petersen Neurospine, Pllc | Orthopaedic Surgery | 6701 Airport Blvd Ste D100, Mobile, AL 36608-6765 | 2019-09-30 |
1396244307 | Select Health of Al, LLC | Orthopaedic Surgery | 202a Government St, Mobile, AL 36602-2614 | 2018-02-05 |
1497254403 | Joint Replacement Cin of Mobile LLC | Orthopaedic Surgery | 202b Government St, Mobile, AL 36602-2614 | 2018-02-05 |
1801310362 | Kivanc Atesok | Orthopaedic Surgery | Uab Division of Orthopaedic Surgery 510 20th, Birmingham, AL 35294-0001 | 2017-07-26 |
1467755405 | University Orthopaedic Clinic, PC | Orthopaedic Surgery | 241 Robert K Wilson Drive, Carrolton, AL 35447-0478 | 2010-12-14 |
1871713032 | Obrien Orthopedic PC | Orthopaedic Surgery | 6490 Highway 72, Athens, AL 35645 | 2007-04-27 |
1689723868 | Timothy A. Holt | Orthopaedic Surgery | 257 Winton M Blount Loop, Montgomery, AL 36117-3507 | 2007-01-09 |
1356325138 | Southeastern Spine Specialists Inc | Orthopaedic Surgery | 1781 Commons North Loop, Tuscaloosa, AL 35406-3577 | 2005-12-05 |
1053807230 | Chong Weng | Orthopaedic Surgery | 510 20th St S, Birmingham, AL 35233-2028 | 2018-07-10 |
1437411675 | John Rodriguez-feo IIi | Orthopaedic Surgery | 927 Franklin St Se, Huntsville, AL 35801-4306 | 2012-06-13 |
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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.