Gonzalez, Juan Carlos

Gonzalez, Juan Carlos is an individual health care provider with primary practice located at 1107 Memorial Dr Ste 102 , Dalton GA 30720-8662. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Gonzalez, Juan Carlos can be contacted via phone (706) 275-6121.

Contact Information

Primary practice address
1107 Memorial Dr Ste 102 Dalton GA 30720-8662
Phone: (706) 275-6121
Fax: (706) 275-0521
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 068737 Georgia
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 068737 Georgia

Profile Details

NPI number 1891891560
LBN Legal business name Gonzalez, Juan Carlos
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2006
Last updated Jan 25th, 2024 - about 10 months 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 1891891560 NPPES
Georgia Other 1072595 WELLCARE
Georgia Other P01332068 WELLCARE
Georgia Other 01934817 WELLCARE
Georgia MEDICAID 512581223F WELLCARE

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