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General NPI Number Information
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NPI Number | 1821030792
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Entity Type | Individual
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Provider Name | PHILIP R GOULD M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 439 US HIGHWAY 158 W
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City | YANCEYVILLE
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State | NC
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Zip | 27379-8304
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Country | US
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Telephone | 336-694-9331
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Fax | 336-694-4209
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Provider Business Mailing Address
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Address Line | 439 US HIGHWAY 158 W
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City | YANCEYVILLE
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State | NC
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Zip | 27379-8304
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Country | US
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Telephone | 336-694-9331
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Fax | 336-694-4209
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME 17023
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | ME17023
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 2013-00445
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2013-00445
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License Number State | NC
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