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:
Health care specialties
Specialty | Code | License # | 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 8 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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