MEDICARE: GORDON L WEBB M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QX0100X	Occupational Medicine Clinic/Center

General Provider Information

NPI Number	:	1063545127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GORDON L WEBB M.D.

Provider Business Mailing Address
First Line	:	3018 JACKSON ST
Second Line	:	SUITE 100
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-4743
Country	:	US
Telephone Number	:	318-561-8200
Fax Number	:	318-651-8204

Provider Business Practice Location Address
First Line	:	3018 JACKSON ST
Second Line	:	SUITE 100
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-4743
Country	:	US
Telephone Number	:	318-561-8200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	07/08/2007

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