Provider Demographics
NPI:1932213071
Name:GOULD, WILLIAM DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DAVID
Last Name:GOULD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3204 BOB WHITE PL
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-3364
Mailing Address - Country:US
Mailing Address - Phone:937-268-6511
Mailing Address - Fax:937-262-5998
Practice Address - Street 1:4100 W 3RD ST
Practice Address - Street 2:DAYTON VAMC, PCL (LLC)
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45428-9000
Practice Address - Country:US
Practice Address - Phone:937-268-6511
Practice Address - Fax:937-262-5998
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2012-07-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH66034207QA0505X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine