Provider Demographics
NPI:1952526758
Name:GLD SERVICES, LLC
Entity Type:Organization
Organization Name:GLD SERVICES, LLC
Other - Org Name:GORDON DUBOIS DC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:A
Authorized Official - Last Name:DUBOIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:504-905-9985
Mailing Address - Street 1:PO BOX 750400
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70175
Mailing Address - Country:US
Mailing Address - Phone:504-861-7167
Mailing Address - Fax:504-861-7168
Practice Address - Street 1:7605 MAPLE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5047
Practice Address - Country:US
Practice Address - Phone:504-861-7167
Practice Address - Fax:504-861-7168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1007111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4825650360OtherBLUE CROSS BLUE SHIELD
LA4825650360OtherBLUE CROSS BLUE SHIELD
T01267Medicare UPIN