Provider Demographics
NPI:1124021399
Name:GOULD, JEFFREY DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DAVID
Last Name:GOULD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 W STATE ST
Mailing Address - Street 2:SUITE 207A
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2567
Mailing Address - Country:US
Mailing Address - Phone:215-345-2962
Mailing Address - Fax:215-345-2029
Practice Address - Street 1:847 EASTON RD STE 2700
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2909
Practice Address - Country:US
Practice Address - Phone:215-345-0105
Practice Address - Fax:215-345-0562
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD063872L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2555611OtherAETNA
PAP00044216OtherRR MEDICARE
PA3Y1480OtherHEALTH NET
PA950564403OtherCIGNA
PA0017122560003Medicaid
PA975702OtherBLUE SHIELD
PAI75702OtherAMERIHEALTH ADMIN. TPA
PAP2542853OtherOXFORD
PAG84074Medicare UPIN
02349000OtherCAPITAL BLUE CROSS