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General NPI Number Information
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NPI Number | 1477550192
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Entity Type | Organization
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Legal Business Name | GORDIAN MEDICAL X, INC.
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 1097 WESTON DR SUITE B
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City | MOUNT JULIET
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State | TN
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Zip | 37122
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Country | US
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Telephone | 615-601-3678
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Fax | 877-380-8282
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Provider Business Mailing Address
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Address Line | 750 THE CITY DR S STE 225
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City | ORANGE
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State | CA
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Zip | 92868-4976
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Country | US
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Telephone | 714-556-0200
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Fax | 877-380-8282
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY BOWMAN
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Credential |
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Telephone | 714-556-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0000000803
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License Number State | TN
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