| John W. Gonzalez, Md Inc | |
|
501 E Hospital Ln Suite 104 Terre Haute IN 47802-4230 | |
| (812) 232-5518 | |
| Not Available |
| Full Name | John W. Gonzalez, Md Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 501 E Hospital Ln, Terre Haute, Indiana |
| Authorized Official Name and Position | John Winston Gonzalez (PRESIDENT) |
| Authorized Official Contact | 8122325518 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John W. Gonzalez, Md Inc 501 E Hospital Ln Suite 104 Terre Haute IN 47802-4230 Ph: (812) 232-5518 | John W. Gonzalez, Md Inc 501 E Hospital Ln Suite 104 Terre Haute IN 47802-4230 Ph: (812) 232-5518 |
| NPI Number | 1669648572 |
|---|---|
| Provider Enumeration Date | 05/01/2008 |
| Last Update Date | 04/02/2024 |
| Certification Date | 04/02/2024 |
| Medicare PECOS PAC ID | 9335228337 |
|---|---|
| Medicare Enrollment ID | O20080501000599 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669648572 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 01052463 (Indiana) | Primary |
| Provider Name | John Winston D Gonzalez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851471163 PECOS PAC ID: 6305925504 Enrollment ID: I20080429000709 |
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