Organization
VIDALIA UROLOGY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GILBERT GONZALEZ (MD)
(912) 537-9481
Entity
Organization
Contact information
Practice address
120A VICTORY DR, SWAINSBORO, GA 30401-3235
(912) 537-9481
(912) 537-1380
Mailing address
303 HARRIS INDUSTRIAL BLVD, SUITE 5, VIDALIA, GA 30474-8853
(912) 537-9481
(912) 537-1380
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
026533
GA
Other
Enumeration date
12/03/2008
Last updated
12/03/2008
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