| R.b. Gonzales Medical And Bariatric Center Inc. | |
|
1361 Fort Harrison Rd Terre Haute IN 47804 | |
| (812) 235-4000 | |
| (812) 235-4004 |
| Full Name | R.b. Gonzales Medical And Bariatric Center Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1361 Fort Harrison Rd, Terre Haute, Indiana |
| Authorized Official Name and Position | Bobbie Clark (M.A.) |
| Authorized Official Contact | 8122354000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| R.b. Gonzales Medical And Bariatric Center Inc. 1361 Fort Harrison Rd Terre Haute IN 47804 Ph: (812) 235-4000 | R.b. Gonzales Medical And Bariatric Center Inc. 1361 Fort Harrison Rd Terre Haute IN 47804 Ph: (812) 235-4000 |
| NPI Number | 1598842254 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 06/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598842254 | NPI | - | NPPES |
| 100326570 | Medicaid | IN | |
| 200041630A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 01052731A (Indiana) | Secondary |
| 132700000X | Dietary Manager | (Indiana) | Secondary |
| 207R00000X | Internal Medicine | 01035596 (Indiana) | Primary |
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