Provider Demographics
NPI:1134501570
Name:GORDON, ALISON LEIGH (PHARMD, BCPS)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:LEIGH
Last Name:GORDON
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:MISS
Other - First Name:ALISON
Other - Middle Name:LEIGH
Other - Last Name:SEAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD, BCPS
Mailing Address - Street 1:149 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:LA
Mailing Address - Zip Code:71463
Mailing Address - Country:US
Mailing Address - Phone:318-335-1360
Mailing Address - Fax:318-335-9918
Practice Address - Street 1:149 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:LA
Practice Address - Zip Code:71463
Practice Address - Country:US
Practice Address - Phone:318-335-1360
Practice Address - Fax:318-335-9918
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0008174183500000X
LAPST.020176183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist