Provider Demographics
NPI:1780795906
Name:RIVERA, FRANCISCO GOZUM (MD)
Entity type:Individual
Prefix:MR
First Name:FRANCISCO
Middle Name:GOZUM
Last Name:RIVERA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 277
Mailing Address - Street 2:
Mailing Address - City:MC DOWELL
Mailing Address - State:KY
Mailing Address - Zip Code:41647-0277
Mailing Address - Country:US
Mailing Address - Phone:606-377-2492
Mailing Address - Fax:606-377-1018
Practice Address - Street 1:9788 KY RT 122
Practice Address - Street 2:STE 2
Practice Address - City:MC DOWELL
Practice Address - State:KY
Practice Address - Zip Code:41647-6042
Practice Address - Country:US
Practice Address - Phone:606-377-2492
Practice Address - Fax:606-377-1018
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY21584208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
020023894OtherPALMETTO RAILROAD MEDICAR
020364400OtherFEDERAL BLACK LUNG/DOL
000000000837OtherCHA HEALTH
000000048788OtherANTHEM BLUE CROSS/SHIELD
230264400OtherDEPT OF LABOR/ACS UNIT/WO
0303224OtherUMWA
KY64215841Medicaid
C64809Medicare UPIN
020023894OtherPALMETTO RAILROAD MEDICAR