Basic Information
| Provider Information | |||||||||
| NPI: | 1548422868 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VILLAR-GOSALVEZ | ||||||||
| FirstName: | CARLOS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2895 | ||||||||
| Address2: | |||||||||
| City: | CULLMAN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350562895 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567355075 | ||||||||
| FaxNumber: | 2567355076 | ||||||||
| Practice Location | |||||||||
| Address1: | 1948 AL HIGHWAY 157 STE 450 | ||||||||
| Address2: | |||||||||
| City: | CULLMAN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350580643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567355075 | ||||||||
| FaxNumber: | 2567355075 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2008 | ||||||||
| LastUpdateDate: | 09/23/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD.38238 | AL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.