| Alan R Gould Dds Ms Llc | |
|
5805 W Highway 22 Crestwood KY 40014-7244 | |
| (502) 241-7116 | |
| (502) 241-2339 |
| Full Name | Alan R Gould Dds Ms Llc |
|---|---|
| Speciality | Dentist |
| Location | 5805 W Highway 22, Crestwood, Kentucky |
| Authorized Official Name and Position | Alan R Gould (ORAL & MAXILLOFACIAL PATHOLOGIST) |
| Authorized Official Contact | 5022417116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alan R Gould Dds Ms Llc 1169 Eastern Pkwy Suite G71 Louisville KY 40217-1417 Ph: (502) 456-6217 | Alan R Gould Dds Ms Llc 5805 W Highway 22 Crestwood KY 40014-7244 Ph: (502) 241-7116 |
| NPI Number | 1558370031 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 01/13/2017 |
| Medicare PECOS PAC ID | 1951293950 |
|---|---|
| Medicare Enrollment ID | O20040325001181 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558370031 | NPI | - | NPPES |
| DC2238 | Other | RAILROAD MEDICARE | |
| 200022760B | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | 4925 (Kentucky) | Primary |
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | 12010715A (Indiana) | Secondary |
| Provider Name | Alan R Gould |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1043229545 PECOS PAC ID: 2062304967 Enrollment ID: I20040409000005 |
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