Provider Demographics
NPI:1932441268
Name:GOSS, DAVID ALBERT JR (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALBERT
Last Name:GOSS
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 W WILSON BRIDGE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2217
Mailing Address - Country:US
Mailing Address - Phone:614-895-8747
Mailing Address - Fax:614-895-3246
Practice Address - Street 1:350 W WILSON BRIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085
Practice Address - Country:US
Practice Address - Phone:614-895-8747
Practice Address - Fax:614-895-3246
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH34.012324207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty