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General NPI Number Information
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NPI Number | 1497915227
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Entity Type | Individual
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Provider Name | JASON GORDON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | USS GEORGE WASHINGTON (CVN 73) 1562 MITSCHER AVE SUITE 250
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City | NORFOLK
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State | VA
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Zip | 23551-2487
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Country | US
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Telephone | 757-836-5929
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Fax |
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Provider Business Mailing Address
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Address Line | USS GEORGE WASHINGTON (CVN 73) UNIT 100148 BOX 1
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City | FPO
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State | AE
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Zip | 09550
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 154668
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2009-01416
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 154668
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number | 154668
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License Number State | NC
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