Provider Demographics
NPI:1013936111
Name:SIGMUND S GOULD MD PA
Entity Type:Organization
Organization Name:SIGMUND S GOULD MD PA
Other - Org Name:GOULD EYE CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIGMUND
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-274-2441
Mailing Address - Street 1:405 PARKWAY
Mailing Address - Street 2:STE B
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401
Mailing Address - Country:US
Mailing Address - Phone:336-274-2441
Mailing Address - Fax:336-274-2565
Practice Address - Street 1:405 PARKWAY
Practice Address - Street 2:STE B
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-274-2441
Practice Address - Fax:336-274-2565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1951152W00000X
NC21562207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8936504Medicaid
NC=========OtherTAX ID
NC8936504Medicaid
NC0216270001Medicare NSC
NC=========OtherTAX ID