Individual
EDUARDO R GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
145 NEWCOMB AVE, MOUNT VERNON, KY 40456-2733
(606) 256-2195
Mailing address
PO BOX 32364, KNOXVILLE, TN 37930-2364
(865) 531-6070
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
30038
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000354933
BCBS
KY
05
—
64300387
—
KY
Enumeration date
02/20/2007
Last updated
07/13/2007
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