Individual
JASON E GONZAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 260-2900
(608) 260-2977
Mailing address
700 S PARK ST, MADISON, WI 53715-1830
(608) 260-2900
(608) 260-2977
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
51710-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710026430
—
WI
Enumeration date
02/06/2007
Last updated
11/17/2020
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