MEDICARE: JOSEPH MACK GOULD DPM

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
1	213E00000X	Podiatrist	1561	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689677288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH MACK GOULD DPM

Provider Business Mailing Address
First Line	:	PO BOX 1056
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-1056
Country	:	US
Telephone Number	:	817-757-0037
Fax Number	:

Provider Business Practice Location Address
First Line	:	178 OAK HILL DR
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76087-7453
Country	:	US
Telephone Number	:	817-757-0037
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	05/31/2023

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