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General NPI Number Information
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NPI Number | 1467435727
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Entity Type | Individual
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Provider Name | CHARLES FRANK GOULD JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 08/19/2019
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Provider Practice Location Address
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Address Line | 1 JARRETT WHITE RD
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City | TRIPLER ARMY MEDICAL CENTER
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State | HI
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Zip | 96859
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Country | US
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Telephone | 808-772-1641
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Fax |
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Provider Business Mailing Address
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Address Line | 775 N KALAHEO AVE
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City | KAILUA
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State | HI
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Zip | 96734-1970
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Country | US
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Telephone | 808-772-1950
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD13035
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License Number State | HI
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