Organization
SERGIO G GONZALEZ MD PA
Active
Organization
SERGIO G GONZALEZ MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SERGIO G GONZALEZ MD (DIRECTOR)
(601) 649-5842
Entity
Organization
Contact information
Practice address
119 SOUTH 12TH AVENUE, LAUREL, MS 39440-4322
(601) 425-9763
(601) 428-5360
Mailing address
119 SOUTH 12TH AVENUE, LAUREL, MS 39440-4322
(601) 425-9763
(601) 428-5360
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
6914
MS
208D00000X
General Practice Physician
06914
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00013124
—
MS
01
—
512G70024
MEDICARE GROUP
MS
Enumeration date
06/21/2005
Last updated
01/24/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up