Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Lucius Nmn Gordon Jr., PA-C

Individual provider Physician Assistant · NPI 1396814778

Mr. Lucius Nmn Gordon Jr., PA-C is a Physician Assistant in Roy, Utah. Works from 3 locations. Licensed in Utah.

Licensed in
UT
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

5640 S 3500 W
Roy, UT 84067-9158
Phone: (801) 773-2838
Fax: (801) 773-3025
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 4301 Mow-Way Road, Fort Sill, OK 73503-6300 — (580) 458-2134
  • 4301 Mow-Way Road, Fort Sill, OK 73503-6300 — (580) 458-2134

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10495233-1206 (UT)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1396814778
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 7, 2006
Last updated in NPPESMarch 17, 2018

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