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NPI Code Detail

MEDICARE: HANNAH E GORDON

MEDICARE: HANNAH E 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
1363A00000XPhysician AssistantWV

General Provider Information

NPI Number : 1619836053
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH E GORDON
Provider Business Mailing Address
First Line : PO BOX 1482
Second Line :
City : SOPHIA
State : WV
Zip : 25921-1482
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 122 12TH ST
Second Line :
City : PRINCETON
State : WV
Zip : 24740-2312
Country : US
Telephone Number : 304-487-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2026
Last Update Date : 01/21/2026

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Directions to “ HANNAH E GORDON ” Practice Location

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