Provider Demographics
NPI:1346779816
Name:GONZALEZ, HERMAN (DO)
Entity Type:Individual
Prefix:DR
First Name:HERMAN
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1919 S WHEELING AVE, LOWER LEVEL
Mailing Address - Street 2:BERNSEN MEDICAL PLAZA SUITE 100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5420
Mailing Address - Country:US
Mailing Address - Phone:918-748-7890
Mailing Address - Fax:918-403-6300
Practice Address - Street 1:1919 S WHEELING AVE, LOWER LEVEL
Practice Address - Street 2:BERNSEN MEDICAL PLAZA SUITE 100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5420
Practice Address - Country:US
Practice Address - Phone:918-748-7890
Practice Address - Fax:918-403-6300
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK6408207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine