Organization
INFANT JESUS PEDIATRICS PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA D GONZALES MD (MEDICAL DIRECTOR)
(804) 458-1430
Entity
Organization
Contact information
Practice address
505 NORTH 6TH AVE, HOPEWELL, VA 23860-2618
(804) 458-1430
(804) 458-8857
Mailing address
505 N 6TH AVE, HOPEWELL, VA 23860-2618
(804) 458-1430
(804) 458-8857
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101026123
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538131625
DR HERMES DIZON NPI
—
01
—
1891720074
DR PATRICIA GONZALES NPI
—
Enumeration date
05/07/2007
Last updated
04/01/2021
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