NPI 1053723643

Kevin Gordon

Practitioner Contractor Tulsa, OK

Practice location

Address: 12222 E 30th St, Tulsa, OK 74129-8423
Phone: (918) 813-6340

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X

Other Contractor providers in Oklahoma →

Registry record

NPI: 1053723643
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 May 2014
Record last updated: 29 May 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.