Individual
FEDERICO GONZALEZ-FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5017
(601) 984-5042
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5017
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
225230
NY
207ZP0101X
Anatomic Pathology Physician
Primary
23727
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03731244
—
MS
Enumeration date
02/03/2006
Last updated
01/18/2017
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