Individual
NESTOR RUBEN GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 WELL PARK LANE, STE 1, CAMPBELLSVILLE, KY 42718
(270) 692-3161
(270) 692-5155
Mailing address
320 N LORETTO RD, LEBANON, KY 40033-1300
(270) 692-3161
(270) 692-5155
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
43819
KY
390200000X
Student in an Organized Health Care Education/Training Program
11011414A
IN
390200000X
Student in an Organized Health Care Education/Training Program
FT335
KY
Other
Enumeration date
03/07/2007
Last updated
05/09/2023
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