Provider Demographics
NPI:1457686198
Name:OLINGER, GORDON NORDELL (MD)
Entity Type:Individual
Prefix:DR
First Name:GORDON
Middle Name:NORDELL
Last Name:OLINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5108 HORNED OWL WAY
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-2766
Mailing Address - Country:US
Mailing Address - Phone:303-284-9855
Mailing Address - Fax:
Practice Address - Street 1:5108 HORNED OWL WAY
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-2766
Practice Address - Country:US
Practice Address - Phone:303-284-9855
Practice Address - Fax:303-284-9855
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20074208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)