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:
Health care specialties
| Specialty | Code | License # | 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 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952307308 | NPPES |
| Mississippi | Other | 512G70024 | MEDICARE GROUP |
| Mississippi | MEDICAID | 00013124 | MEDICARE GROUP |
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