1326044231 NPI number — ANTONIO R GONZALEZ-RUIZ M.D.

Table of content: ANTONIO R GONZALEZ-RUIZ M.D. (NPI 1326044231)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326044231 NPI number — ANTONIO R GONZALEZ-RUIZ M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GONZALEZ-RUIZ
Provider First Name:
ANTONIO
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326044231
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2006 BROOKWOOD MEDICAL CTR DR
Provider Second Line Business Mailing Address:
WOMEN'S MEDICAL PLAZA, SUITE 604
Provider Business Mailing Address City Name:
HOMEWOOD
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35209-6899
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-877-5113
Provider Business Mailing Address Fax Number:
205-877-5130

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2006 BROOKWOOD MEDICAL CTR DR
Provider Second Line Business Practice Location Address:
WOMEN'S MEDICAL PLAZA, SUITE 604
Provider Business Practice Location Address City Name:
HOMEWOOD
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35209-6899
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-877-5113
Provider Business Practice Location Address Fax Number:
205-877-5130
Provider Enumeration Date:
06/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207VM0101X , with the licence number:  28887 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000064957 . This is a "ANTHEM MEDICAID" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 344428256 . This is a "EMERALD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 344428256 . This is a "BEECH STREET" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: OC02562 . This is a "NATIONWIDE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 124629 . This is a "CARE CHOICES" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 344428256099 . This is a "CARESOURCES" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 3489970 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9180 . This is a "HEALTH PLAN MI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 01616 . This is a "PARAMOUNT" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 4326824 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 124629 . This is a "PRIORITY HEALTH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 19687 . This is a "GREAT LAKES HEALTH CARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0929802 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 344428256 . This is a "FRONTPATH" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: C36324 . This is a "HEALTH ALLICANCE PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 000000064957 . This is a "ANTHEM COMMERICAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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