Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. LUCIUS NMN GORDON JR., PA-C
ActivePhysician Assistant · ROY, UT
Registration Details
- NPI Number
- 1396814778
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 7, 2006 (19.453705204762 yrs)
- Last Updated
- Mar 17, 2018
- License
-
10495233-1206 (UT)
Practice Information
- Address
-
5640 S 3500 WROY, UT, 840679158Browse UT providers · Browse ZIP 84067
- Phone
- 8017732838
- Fax
- 8017733025
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in ROY, UT
| Name | Credential | NPI |
|---|---|---|
| RODNEY K GROGAN | PA-C | 1114915170 |
| JAMES E PARKER | PA-C | 1841270907 |
| RICHARD R RUSSELL | PA | 1184647786 |
| MR. MICHEAL SHAWN DAWSON | PA-C | 1376853036 |
| VAN J ASTON | PA-C | 1548530140 |
| TRACI LYNN WOOD | PA-C | 1659643385 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.