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Jodie Elizabeth Gordon

Optometrist

Eye and Vision Services Providers

13301 Hall Rd, Shelby Township, MI 48315-5835

PECOS Enrollment

This provider is enrolled in PECOS as JODIE GORDON.

Based on the most recent information from CMS, provider Jodie Elizabeth Gordon is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1962559203
Provider Type
Individual
Full Name
Gordon, Jodie Elizabeth
Credential
O.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
1/5/2007
Last Updated
7/8/2007

Contact Information

Practice Location

13301 Hall Rd, Shelby Township, MI 48315-5835

(810) 726-0290

Unlisted Fax

Mailing Location

13301 Hall Rd, Shelby Twp, MI 48315-5835

(586) 726-9257

(586) 726-0514

Provider Taxonomies

Code	Description	License
Code 152W00000X Primary	Description Optometrist Eye and Vision Services Providers	License 4901004268 Michigan

Jodie Elizabeth Gordon

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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