Individual provider · Type 1 NPI

Ellen R. Gordon, MD

Student in an Organized Health Care Education/Training Program · Madison, WI

NPI number 1275910168 Active

Practice location

3209 Dryden Dr
Madison, WI 53704-3015

Call (608) 241-9020 Map

Fax (608) 274-0310

Mailing address

7974 Uw Health Ct
Middleton, WI 53562-5531

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1275910168

Ellen R. Gordon, MD's National Provider Identifier is 1275910168, issued on Apr 30, 2015. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Madison, WI. The record was last updated on Apr 30, 2015.