Riley Gorden
Spec/Tech, Pathology in Indianapolis, IN. Individual provider (NPI-1).
NPI number1932881117
StatusActive
Last updated in NPPESAug 7, 2023
Details
- NPI
- 1932881117
- Entity type
- Individual (NPI-1)
- Name
- Mr. Riley Gorden
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 7, 2023
- Certification date
- Aug 6, 2023
- Last updated
- Aug 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246Q00000X | Spec/Tech, Pathology | – | – | Yes |
| 247ZC0005X | Pathology, Clinical Laboratory Director, Non-physician | – | – |
Practice location
320 N Meridian St Ste 906Indianapolis, IN 46204-1727
Phone 317-759-4262 · Fax 317-426-2925
Mailing address
320 N Meridian St Ste 906Indianapolis, IN 46204-1727
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