Gonzalez, Jorge Antonio

Gonzalez, Jorge Antonio is an sole proprietor health care provider with primary practice located at 5010 E 68Th St Ste 102 , Tulsa OK 74136-3341. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Gonzalez, Jorge Antonio can be contacted via phone (918) 236-5881.

Contact Information

Primary practice address
5010 E 68Th St Ste 102 Tulsa OK 74136-3341
Fax: (918) 236-5885
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 19558 Oklahoma

Profile Details

NPI number 1073567392
LBN Legal business name Gonzalez, Jorge Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 20th, 2006
Last updated Jun 11th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073567392 NPPES
Oklahoma MEDICAID 100020260C

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