Edward I Gordon (NPI# 1891727830, PAC ID# 2365584364) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1891727830 |
| PAC ID by PECOS | 2365584364 |
| Professional Enrollment ID | I20100128000346 |
| Full Name | Edward I Gordon |
| Organization Legal Name | WOODLAND FAMILY PRACTICE LLC |
| Address |
202 Agee St Farmville VA 23901-2617 |
| Phone Number | 4343926143 |
| Gender | M |
| Medical School | UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE |
| Graduation Year | 1971 |
| Primary Specialty | FAMILY PRACTICE |
| Secondary Specialties | ALLERGY/IMMUNOLOGY, GENERAL PRACTICE, PEDIATRIC MEDICINE |
| Group Practice PAC ID | 7911191093 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490021 | CENTRA HEALTH, INC |
| 490090 | SOUTHSIDE COMMUNITY HOSPITAL, INC |
| Address | Phone | Organization |
|---|---|---|
| 202 Agee St, Farmville, VA 23901-2617 | 4343926143 | WOODLAND FAMILY PRACTICE LLC |
| Organization Legal Name | WOODLAND FAMILY PRACTICE LLC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lawrence C Varner | Family Practice | Woodland Family Practice LLC | 202 Agee St, Farmville, VA 23901-2617 |
| Eugene A Donovan | Internal Medicine | Woodland Family Practice LLC | 2003 Cobb St, Farmville, VA 23901-2603 |
| Jorge A Capo | General Practice | Woodland Family Practice LLC | 202 Agee St, Farmville, VA 23901-2617 |
| Street Address |
202 AGEE ST |
| City | FARMVILLE |
| State | VA |
| Zip | 23901-2617 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marion L Kyner | Certified Clinical Nurse Specialist (cns) | 202 Agee St, Farmville, VA 23901-2617 | |
| Lawrence C Varner | Family Practice | Woodland Family Practice LLC | 202 Agee St, Farmville, VA 23901-2617 |
| Jorge A Capo | General Practice | Woodland Family Practice LLC | 202 Agee St, Farmville, VA 23901-2617 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrea Blaisdell | Physical Therapy | Centra Outpatient Rehabilitation Services LLC | 935 Main St, Farmville, VA 23901 |
| Rhian Mccann | Physical Therapy | Centra Outpatient Rehabilitation Services LLC | 935 Main St, Farmville, VA 23901 |
| Jonathan Lundberg | Physical Therapy | Centra Outpatient Rehabilitation Services LLC | 935 Main St, Farmville, VA 23901 |
| Jennifer Mohan | Speech Language Pathologist | Centra Outpatient Rehabilitation Services LLC | 935 Main St, Farmville, VA 23901 |
| Sarah Parker | Speech Language Pathologist | Centra Outpatient Rehabilitation Services LLC | 935 Main St, Farmville, VA 23901 |
| Shashidharan B Ayer | Nephrology | 1801 E 3rd St, Farmville, VA 23901-0245 | |
| Ripon W La Roche | Ophthalmology | Southside Eye Center PC | 1511 W 3rd St, Farmville, VA 23901-0506 |
| St Claire R La Roche | Optometry | Southside Eye Center PC | 1511 W 3rd St, Farmville, VA 23901-0506 |
| Ripon W La Roche Iii | Optometry | Southside Eye Center PC | 1511 W 3rd St, Farmville, VA 23901-0506 |
| Edwina C Wilson | Family Medicine | Central Virginia Health Services Inc | 833 Buffalo St, Farmville, VA 23901-1111 |
| Find all physicians in zip 23901 | |||
| City | FARMVILLE |
| Zip Code | 23901 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | FARMVILLE + FAMILY PRACTICE |
Please comment or provide details below to improve the information on Edward I Gordon.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.