Gonzalez, Jorge Luis

Gonzalez, Jorge Luis is an individual health care provider with primary practice located at 1 Medical Center Drive , Lebanon NH 03753. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology, which is considered as his primary health care specialty. Gonzalez, Jorge Luis can be contacted via phone (603) 650-7215.

Contact Information

Primary practice address
1 Medical Center Drive Lebanon NH 03753
Phone: (603) 650-7215
Fax: (603) 650-7214
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology 207ZP0101X 9079 New Hampshire

Profile Details

NPI number 1407887060
LBN Legal business name Gonzalez, Jorge Luis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Jul 8th, 2007 - about 17 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 1407887060 NPPES
Vermont MEDICAID 0RE2924
Vermont MEDICAID 80002924

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