SERGIO G GONZALEZ (NPI# 1366443210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366443210 |
| Entity Type | Individual |
| Full Name | SERGIO G GONZALEZ |
| Credential | MD |
| Practice Address |
119 S 12th Ave Laurel MS 39440-4322 |
| Practice Telephone | 6016495842 |
| Practice Fax Number | 6016490726 |
| Mailing Telephone | 6016495842 |
| Mailing Fax Number | 6016490726 |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207ZD0900X |
Pathology Specialization: Dermatopathology |
06914 | MS | Allopathic & Osteopathic Physicians |
| X | 208D00000X | General Practice | 06914 | MS | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922661594 | Sergio Gonzalez | Nurse Practitioner | 1910 Suncrisp Ln, Bakersfield, CA 93312-2683 | 2019-04-18 |
| 1336599133 | Sergio Gonzalez | Behavioral Analyst | 8546 Broadway St Ste 200, San Antonio, TX 78217-6340 | 2016-06-13 |
| 1497115588 | Sergio Ed Gonzalez Jr. | Physical Therapist | 2815 Mimosa St Apt 2a, Mission, TX 78574-3812 | 2016-03-02 |
| 1821646571 | Sergio Gonzalez | Counselor | 8 Sun St, Salinas, CA 93901-3714 | 2019-08-27 |
| 1386146777 | Sergio Gonzalez | Pharmacist | 300 W Huntington Dr, Arcadia, CA 91007-3402 | 2018-03-02 |
| 1154776821 | Sergio Gonzalez | Dental Hygienist | 10435 Greenbough Dr, Suite 300, Stafford, TX 77477-5000 | 2016-04-29 |
| 1437503109 | Sergio Gonzalez | Counselor | 504 W Vista Way, Vista, CA 92083-5704 | 2016-04-19 |
| 1487985016 | Sergio Gonzalez | Nurse Anesthetist, Certified Registered | 1011 14th Ave Nw, Ardmore, OK 73401-1828 | 2010-01-21 |
| 1689868721 | Sergio Antonio Gonzalez | Family Medicine | 950 Circle Dr, Salinas, CA 93905-2150 | 2007-08-31 |
| 1841327798 | Sergio Gonzalez Jr. | Social Worker | 333 S Beaudry Ave, Los Angeles, CA 90017-1466 | 2007-02-27 |
| Street Address |
119 S 12TH AVE |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902443856 | Sade Symone Hollingsworth | Social Worker | 119 S 12th Ave, Laurel, MS 39440-4322 | 2019-12-10 |
| 1366089211 | Lauren Antoinette House | Counselor | 119 S 12th Ave, Laurel, MS 39440-4322 | 2019-12-10 |
| 1205485885 | Samantha Brown | Counselor | 119 S 12th Ave, Laurel, MS 39440-4322 | 2019-09-06 |
| 1396307179 | Jaquay Jackson | Counselor | 119 S 12th Ave, Laurel, MS 39440-4322 | 2019-07-02 |
| 1538729686 | Devona Pugh | Social Worker | 119 S 12th Ave, Laurel, MS 39440-4322 | 2019-06-19 |
| 1679139984 | Apryle Olivia Cunningham | Social Worker | 119 S 12th Ave, Laurel, MS 39440-4322 | 2019-05-13 |
| 1629535497 | Lakeisha Lashun Roberts | Counselor | 119 S 12th Ave, Laurel, MS 39440-4322 | 2019-02-27 |
| 1336615269 | Cheryl Jones | Social Worker | 119 S 12th Ave, Laurel, MS 39440-4322 | 2018-10-18 |
| 1598231508 | Jennifer Marie Jones | Counselor | 119 S 12th Ave, Laurel, MS 39440-4322 | 2018-10-17 |
| 1477538072 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 119 S 12th Ave, Laurel, MS 39440-4322 | 2005-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
| 1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
| 1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
| 1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| Find all providers in zip 39440 | ||||
| Taxonomy Code | 207ZD0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Dermatopathology |
| A dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source added] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. A subspecialty certificate was first issued by the ABMS in 1974. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740572676 | Buu Duong | Pathology | 3120 Old Canton Rd, Jackson, MS 39216-4219 | 2011-05-11 |
| 1033432653 | Jennifer S Schulmeier | Pathology | 3120 Old Canton Rd, Jackson, MS 39216-4219 | 2010-03-10 |
| 1063735686 | Billy L Walker | Pathology | 3120 Old Canton Rd, Jackson, MS 39216-4219 | 2010-03-10 |
| 1770672768 | Hattiesburg Clinic Pa | Pathology | 421 S 28th Ave, Suite 310, Hattiesburg, MS 39401-7206 | 2006-10-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.