Individual provider · Type 1 NPI

Charlie J. Gordon Iii

Driver · Milwaukee, WI

NPI number 1457561045 Active

Practice location

1000 N 92nd St
Milwaukee, WI 53226-3533

Call (414) 479-9400 Map

Fax (414) 259-1663

Mailing address

3730 W Capitol Dr
Milwaukee, WI 53216-2539

Specialties and licenses

TaxonomyCodeLicense
Driver Primary 172A00000XG635-1107-1325-04 (WI)

Driver: A person employed to operate a motor vehicle as a carrier of persons or property.

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About NPI 1457561045

Charlie J. Gordon Iii's National Provider Identifier is 1457561045, issued on May 23, 2007. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Milwaukee, WI. The record was last updated on Jul 8, 2007.