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General NPI Number Information
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NPI Number | 1851471163
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Entity Type | Individual
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Provider Name | JOHN WINSTON DONATO GONZALEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | 501 E HOSPITAL LN SUITE 104
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4230
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Country | US
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Telephone | 812-232-5518
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Fax | 812-235-8908
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Provider Business Mailing Address
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Address Line | 501 E HOSPITAL LN SUITE 104
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4230
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Country | US
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Telephone | 812-232-5518
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Fax | 812-235-8908
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 01045263
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 01052463A
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License Number State | IN
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