Provider Demographics
NPI:1891685202
Name:GORDON, KYLE D
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:D
Last Name:GORDON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 BRANSFORD AVE APT 650
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3298
Mailing Address - Country:US
Mailing Address - Phone:662-832-0331
Mailing Address - Fax:
Practice Address - Street 1:113 CUMBERLAND AVE STE 110
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-3339
Practice Address - Country:US
Practice Address - Phone:615-596-1830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist