Provider Demographics
NPI:1659595387
Name:GORDON, RODNEY SLOOP (RPH)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:SLOOP
Last Name:GORDON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2421 E TUDOR RD
Mailing Address - Street 2:SUITE #107
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1166
Mailing Address - Country:US
Mailing Address - Phone:907-561-2421
Mailing Address - Fax:907-868-5113
Practice Address - Street 1:2421 E TUDOR RD
Practice Address - Street 2:SUITE #107
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1166
Practice Address - Country:US
Practice Address - Phone:907-561-2421
Practice Address - Fax:907-868-5113
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1342183500000X
VI178183500000X
NC7593183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist