Individual
DR. GONZALO VILLALOBOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 536-2146
(770) 536-7895
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
043143
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000742563J
—
GA
05
—
000742563K
—
GA
05
—
000742563M
—
GA
01
—
000742563N
MEDICAID URGENT CARE FRIENDSHIP
GA
01
—
93BFDXR
MEDICARE PIN URGENT CARE FRIENDSHIP
GA
Enumeration date
01/10/2006
Last updated
04/05/2012
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