Search › Mississippi › 1223G0001X
Olivia Van Gordon
NPI 1598285538 · on the registry since 2017 · sole proprietor
Practice
- Address
- 1800 F S Hill Dr Ste A
Grenada, MS 38901 - Phone
- (662) 226-1757
- Fax
- (662) 307-2709
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 1223G0001X
1223G0001X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-07-21
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi