Individual
DR. JAIME GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1969 WEST HART RD, BELOIT, WI 53511-2283
(608) 364-5011
(608) 364-5452
Mailing address
1969 WEST HART RD, BELOIT, WI 53511-2283
(608) 364-5011
(608) 364-5452
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
73854
WI
207RI0200X
Infectious Disease Physician
Primary
73854-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114306537
—
WI
Enumeration date
05/19/2015
Last updated
07/19/2022
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