| Doctor Name: | DOUGLAS M GORDON |
| NPI Number: | 1144397217 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | ME64194 |
| Business Practice Address: | 701 W Cocoa Beach Cswy Cocoa Beach, FL - 329313585 |
| Business Phone Number: | 3217997111 |
| Business Fax Number: | 7706213181 |
| Mailing Address: | Po Box 2400, MELBOURNE |
| State: | FL |
| Postal Code: | 329022400 |
| Phone Number: | 8667441461 |
| Fax Number: | 7706213181 |
| NPI Enumeration Date: | 11/30/2006 |
| NPI Last Update Date: | 08/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | ME64194 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |