Sergio G Gonzalez Md Pa

LBN: Sergio G Gonzalez Md Pa
Sergio G Gonzalez Md Pa is an health care organization with primary practice located at 119 South 12Th Avenue , Laurel MS 39440-4322. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Dermatopathology is the primary health care specialty. Sergio G Gonzalez Md Pa can be contacted via phone (601) 425-9763, or through Gonzalez, Sergio G via phone (601) 649-5842.

Contact Information

Primary practice address
119 South 12Th Avenue Laurel MS 39440-4322
Phone: (601) 425-9763
Fax: (601) 428-5360
Website:
Map and Directions
Authorized official contact:
Name: Gonzalez, Sergio G Doctor of Medicine (MD)
Phone: (601) 649-5842

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatopathology 207ZD0900X 6914 Mississippi
Allopathic & Osteopathic Physicians / General Practice 208D00000X 06914 Mississippi

Profile Details

NPI number 1952307308
LBN Legal business name Sergio G Gonzalez Md Pa
DBA Doing business as
Authorized official Gonzalez, Sergio G Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 21st, 2005
Last updated Jan 24th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952307308 NPPES
Mississippi Other 512G70024 MEDICARE GROUP
Mississippi MEDICAID 00013124 MEDICARE GROUP

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