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General NPI Number Information
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NPI Number | 1609924174
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Entity Type | Individual
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Provider Name | JORGE TIRADOR GONZALEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 601 W CHISHOLM ST
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City | ALPENA
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State | MI
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Zip | 49707-2426
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Country | US
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Telephone | 989-356-9880
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Fax | 989-356-9890
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Provider Business Mailing Address
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Address Line | 601 W CHISHOLM ST P.O. BOX 296
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City | ALPENA
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State | MI
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Zip | 49707-2426
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Country | US
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Telephone | 989-356-9880
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Fax | 989-356-9890
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD-16258
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 4301066290
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License Number State | MI
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