Provider Demographics
NPI:1669438602
Name:GOULD, BARRY J (DPM)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:J
Last Name:GOULD
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1788 MCFARLAND BLVD N
Mailing Address - Street 2:SUITE B
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2190
Mailing Address - Country:US
Mailing Address - Phone:205-759-9100
Mailing Address - Fax:205-759-1821
Practice Address - Street 1:1788 MCFARLAND BLVD N
Practice Address - Street 2:SUITE B
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2190
Practice Address - Country:US
Practice Address - Phone:205-759-9100
Practice Address - Fax:205-759-1821
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL272204D00000X, 213EP1101X, 213E00000X, 213EP0504X, 213ER0200X, 213ES0000X, 213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
51527950OtherBCBS OF AL
AL118680Medicaid
AL051537935OtherBCBS OF AL
AL051004054OtherBCBS OF AL
AL051537563OtherBCBS OF AL
AL51528212OtherBCBSAL PROVIDER #
AL051555810Medicare PIN
AL051537563Medicare PIN
AL118680Medicaid