Individual
JAY M GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2700 W 9TH AVE, STE 230, OSHKOSH, WI 54904-7247
(920) 223-0220
Mailing address
2700 W 9TH AVE, STE 230, OSHKOSH, WI 54904-7247
(920) 223-0220
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
46930
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43514100
—
WI
Enumeration date
09/06/2005
Last updated
09/02/2008
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