Individual
DR. JUAN CARLOS GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1107 MEMORIAL DR STE 300, DALTON, GA 30720-8662
(706) 275-6121
(706) 275-0521
Mailing address
1107 MEMORIAL DR STE 300, DALTON, GA 30720-8662
(706) 275-6121
(706) 275-0521
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
068737
GA
2084N0400X
Neurology Physician
Primary
068737
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01934817
AMERIGROUP
GA
01
—
1072595
WELLCARE
GA
05
—
512581223F
—
GA
01
—
P01332068
RR MEDICARE
GA
Enumeration date
09/16/2006
Last updated
11/04/2025
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