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NPI Code Detail

MEDICARE: MR. ERNEST EDWARD GOULD JR. R.P.A.

MEDICARE: MR. ERNEST EDWARD GOULD JR. R.P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1243U00000XRadiology Practitioner Assistant08CO1363

General Provider Information

NPI Number : 1871897256
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ERNEST EDWARD GOULD JR. R.P.A.
Provider Business Mailing Address
First Line : 2490 W 26TH AVE STE 220A
Second Line :
City : DENVER
State : CO
Zip : 80211-5385
Country : US
Telephone Number : 303-433-9729
Fax Number :
Provider Business Practice Location Address
First Line : 2490 W 26TH AVE STE 220A
Second Line :
City : DENVER
State : CO
Zip : 80211-5385
Country : US
Telephone Number : 303-433-9729
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2010
Last Update Date : 12/29/2010

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