Individual
JOSE MAURICIO GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2509 MAPLEWOOD DR., SULPHUR, LA 70663
(337) 625-0341
(337) 625-0347
Mailing address
2509 MAPLEWOOD DR, SULPHUR, LA 70663
(337) 625-0341
(337) 625-0347
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22265
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1682969
—
LA
Enumeration date
08/09/2005
Last updated
05/26/2020
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