Individual
JOSE MANUEL VILLALON-GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
740 W PEACHTREE ST NW, ATLANTA, GA 30308-1199
(833) 401-1577
Mailing address
740 W PEACHTREE ST NW, ATLANTA, GA 30308-1199
(833) 401-1577
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
066097
GA
207Q00000X
Family Medicine Physician
246442
NY
207Q00000X
Family Medicine Physician
ME103333
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003109624A
—
GA
Enumeration date
10/05/2008
Last updated
08/18/2024
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