Provider Demographics
NPI:1447455399
Name:RAMIREZ GAVIDIA, JOSE ROBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ROBERTO
Last Name:RAMIREZ GAVIDIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7105 S SPRINGS DR STE 111
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-1720
Mailing Address - Country:US
Mailing Address - Phone:615-988-9686
Mailing Address - Fax:
Practice Address - Street 1:7105 S SPRINGS DR STE 111
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-1720
Practice Address - Country:US
Practice Address - Phone:615-988-9686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000049546208600000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery