Gonzalez, Evangelio
Gonzalez, Evangelio is an individual health care provider with primary practice located at 705 Dallas Hwy Ste 101, Villa Rica GA 30180-1247. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gonzalez, Evangelio can be contacted via phone (770) 456-4411.Contact Information
Primary practice address
705 Dallas Hwy Ste 101
Villa Rica GA 30180-1247
Phone: (770) 456-4411
Fax: (770) 812-3582
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 016234 | Georgia |
Profile Details
| NPI number | 1598739609 |
|---|---|
| LBN Legal business name | Gonzalez, Evangelio |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 15th, 2006 |
| Last updated | Mar 7th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598739609 | NPPES |
| Georgia | MEDICAID | 00191496A |
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