Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 201019 | LA |
NPI | 1003901539 |
---|---|
Provider Name | Dr. Joseph A. Gonzales JR. |
First Address | New Orleans, LA 70118 |
Second Address | New Orleans, LA 70118 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 29/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1502839 | (05) | LA |