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General NPI Number Information
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NPI Number | 1992864052
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Entity Type | Individual
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Provider Name | GLORIA F GOMEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 12/13/2013
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Provider Practice Location Address
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Address Line | 1818 COLLEGE DRIVE
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City | MERIDIAN
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State | MS
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Zip | 39307-5429
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Country | US
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Telephone | 601-581-7600
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Fax | 601-483-5543
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Provider Business Mailing Address
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Address Line | PO BOX 4128
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City | MERIDIAN
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State | MS
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Zip | 39304-4128
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Country | US
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Telephone | 601-581-7600
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Fax | 601-483-5543
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 10572
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License Number State | MS
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