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NPI Code Detail

MEDICARE: DR. PHILIP R GOULD M.D.

MEDICARE: DR. PHILIP R GOULD M.D.
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
1207R00000XInternal Medicine PhysicianME 17023FL
2207RG0300XGeriatric Medicine (Internal Medicine) PhysicianME17023FL
3207RG0300XGeriatric Medicine (Internal Medicine) Physician2013-00445NC
4207R00000XInternal Medicine Physician2013-00445NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
119BMROTHERNCBCBSNC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821030792
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHILIP R GOULD M.D.
Provider Business Mailing Address
First Line : 439 US HIGHWAY 158 W
Second Line :
City : YANCEYVILLE
State : NC
Zip : 27379-8304
Country : US
Telephone Number : 336-694-9331
Fax Number : 336-694-4209
Provider Business Practice Location Address
First Line : 439 US HIGHWAY 158 W
Second Line :
City : YANCEYVILLE
State : NC
Zip : 27379-8304
Country : US
Telephone Number : 336-694-9331
Fax Number : 336-694-4209
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 07/21/2022

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Directions to “ DR. PHILIP R GOULD M.D.” Practice Location

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