Individual
GUS ANTHONY GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 FALLING SKY DR, EDMOND, OK 73034-0808
(417) 544-4147
Mailing address
701 FALLING SKY DR, EDMOND, OK 73034-0808
(417) 544-4147
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
2014027664
MO
207RX0202X
Medical Oncology Physician
2014027664
MO
207RX0202X
Medical Oncology Physician
M6151
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100216400D
—
OK
05
—
1886756-01
—
TX
05
—
1886756-03
—
TX
05
—
1962497594
—
MO
05
—
200016575
—
MO
Enumeration date
09/20/2005
Last updated
06/12/2023
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