Individual
MR. GEORGE P GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2606 GREENWAY DR STE 101, KNOXVILLE, TN 37918-1991
(865) 687-3313
(865) 687-3362
Mailing address
2606 GREENWAY DR STE 101, KNOXVILLE, TN 37918-1991
(658) 687-3313
(865) 687-3362
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA504
TN
363AM0700X
Medical Physician Assistant
Primary
PA504
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3666697
—
TN
Enumeration date
07/05/2006
Last updated
03/30/2022
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