Provider Demographics
NPI:1891968061
Name:OROZCO, GABRIELA PAOLA (MD)
Entity Type:Individual
Prefix:MS
First Name:GABRIELA
Middle Name:PAOLA
Last Name:OROZCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2717 EAST OAKLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-1843
Mailing Address - Country:US
Mailing Address - Phone:423-926-2358
Mailing Address - Fax:423-926-2680
Practice Address - Street 1:2300 PAVILION DR NHC
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660
Practice Address - Country:US
Practice Address - Phone:423-765-9655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN49019207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1891968061Medicaid
TNP01200422OtherRAILROAD MEDICARE PIN
KY7100237990Medicaid
VA1891968061Medicaid
TNQ000283Medicaid
TNQ000283Medicaid