Provider Demographics
NPI:1164615282
Name:GOULD, WALTER H (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:H
Last Name:GOULD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1333 W. 5TH STREET
Mailing Address - Street 2:SUITE #200
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801
Mailing Address - Country:US
Mailing Address - Phone:307-673-3181
Mailing Address - Fax:307-673-3180
Practice Address - Street 1:1333 W. 5TH STREET
Practice Address - Street 2:SUITE #200
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801
Practice Address - Country:US
Practice Address - Phone:307-673-3181
Practice Address - Fax:307-673-3180
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2010-06-29
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Provider Licenses
StateLicense IDTaxonomies
WY2501A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery