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Individual

RICHARD GONZALEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7950 MARTIN LOOP, FORT BENNING, COLUMBUS, GA 31905
(706) 544-3730
Mailing address
400 1ST DIVISION RD, FORT BENNING, COLUMBUS, GA 31905-6809
(706) 544-3730
(706) 544-3163

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
9139
PR

Other

Enumeration date
10/05/2006
Last updated
07/08/2007
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