Provider Demographics
NPI:1891748695
Name:GOLD, JOSEPH FRANK (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FRANK
Last Name:GOLD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 E OLNEY AVE
Mailing Address - Street 2:STE 400
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-2470
Mailing Address - Country:US
Mailing Address - Phone:215-457-7700
Mailing Address - Fax:215-457-0386
Practice Address - Street 1:4817 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-2107
Practice Address - Country:US
Practice Address - Phone:215-457-7700
Practice Address - Fax:215-457-0386
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003311L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0613520Medicaid
PAOS003311LOtherMEDICAL LICENSE
E70573Medicare UPIN
PAOS003311LOtherMEDICAL LICENSE