Provider Demographics
NPI:1396895660
Name:GORTON, ROBERT EUGENE JR (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EUGENE
Last Name:GORTON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 COUNTY ROAD 4707
Mailing Address - Street 2:
Mailing Address - City:KEMPNER
Mailing Address - State:TX
Mailing Address - Zip Code:76539-5625
Mailing Address - Country:US
Mailing Address - Phone:254-287-3796
Mailing Address - Fax:
Practice Address - Street 1:499 COUNTY ROAD 4707
Practice Address - Street 2:
Practice Address - City:KEMPNER
Practice Address - State:TX
Practice Address - Zip Code:76539-5625
Practice Address - Country:US
Practice Address - Phone:254-287-3796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301055340207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine