Provider Demographics
NPI:1811145261
Name:GOLD, JOHN FREDERICK (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:FREDERICK
Last Name:GOLD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1123
Mailing Address - Street 2:255 WEST MICHIGAN AVENUE
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49204-1123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1924 ALCOA HWY
Practice Address - Street 2:BOX U109
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1511
Practice Address - Country:US
Practice Address - Phone:865-305-9220
Practice Address - Fax:865-637-5518
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2013-02-01
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Provider Licenses
StateLicense IDTaxonomies
GA66038207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology