MEDICARE: JACQUELINE GORDON

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	106E00000X	Assistant Behavior Analyst		AL

General Provider Information

NPI Number	:	1265376792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE GORDON

Provider Business Mailing Address
First Line	:	1A JONAH DR
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36869-3639
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1A JONAH DR
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36869-3639
Country	:	US
Telephone Number	:	334-592-8744
Fax Number	:

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

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

Similar Medicare Providers

1912900069 — MS. JANE N. OLLENDORFF R.N., M.S.W.
Practice Location Address:

8128 CORNELL CT
UNIVERSITY CITY, MO
63130-3639

Practice Phone: 314-721-7057
Practice Fax: 314-387-5592

1992776066 — DR. LLOYD G LOGUE DO
Practice Location Address:

527 N PALO ALTO AVE
PANAMA CITY, FL
32401-3639

Practice Phone: 850-763-2451
Practice Fax: 850-747-4907

1730150806 — DR. GREGORY A PRESSER MD
Practice Location Address:

527 N PALO ALTO AVE
PANAMA CITY, FL
32401-3639

Practice Phone: 850-763-2451
Practice Fax: 850-747-4907

1538136395 — BAY RADIOLOGY ASSOCIATES, PL
Practice Location Address:

527 N. PALO ALTO AVE.
PANAMA CITY, FL
32401-3639

Practice Phone: 850-747-4905
Practice Fax: 850-747-4907

1124084371 — DR. EMILY DALE BILLINGSLEY MD
Practice Location Address:

527 N PALO ALTO AVE
PANAMA CITY, FL
32401-3639

Practice Phone: 850-747-4905
Practice Fax: 850-747-4907

1063440162 — DANIEL L COX JR. PAC
Practice Location Address:

527 N PALO ALTO AVE
PANAMA CITY, FL
32401-3639

Practice Phone: 850-747-4905
Practice Fax: 850-747-4907

Directions to “ JACQUELINE GORDON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.