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General NPI Number Information
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NPI Number | 1699753400
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Entity Type | Individual
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Provider Name | YURY R GONZALES MD
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Gender | Male
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 02/25/2013
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Provider Practice Location Address
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Address Line | 2136 W 8TH ST PRICE HILL HEALTH CENTER
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City | CINCINNATI
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State | OH
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Zip | 45204-2052
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Country | US
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Telephone | 513-357-2700
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Fax | 513-357-2750
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Provider Business Mailing Address
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Address Line | 3101 BURNET AVE
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City | CINCINNATI
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State | OH
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Zip | 45229-3098
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Country | US
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Telephone | 513-357-7289
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Fax | 513-357-2750
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35069107G
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License Number State | OH
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