Dr Keith Mcgoldrick, PHD is a
Clinical Neuropsychologist based in Salt Lake City, Utah. Dr Keith Mcgoldrick is licensed to practice in Utah (license number 9524802-2501) and his current practice location is
1733 S 1100 E Ste 102, Salt Lake City, Utah. He can be reached at his office (for appointments etc.) via phone at
(801) 486-6632.
NPI number for Dr Keith Mcgoldrick is 1154565729 and his current mailing address is 1733 S 1100 E Ste 102, Salt Lake City, Utah. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1154565729.
Healthcare Provider's Profile
| Full Name | Dr Keith Mcgoldrick |
|---|
| Gender | Male |
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| Speciality | Clinical Neuropsychologist |
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| Location | 1733 S 1100 E Ste 102, Salt Lake City, Utah |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1154565729
- Provider Enumeration Date: 04/27/2009
- Last Update Date: 11/05/2019
Medical Identifiers
Medical identifiers for Dr Keith Mcgoldrick such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154565729 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | 9524802-2501 (Utah) | Secondary |
| 103TA0700X | Psychologist - Adult Development & Aging | 9524802-2501 (Utah) | Secondary |
| 103TB0200X | Psychologist - Cognitive & Behavioral | 9524802-2501 (Utah) | Secondary |
| 103TC0700X | Psychologist - Clinical | 9524802-2501 (Utah) | Secondary |
| 103TF0200X | Psychologist - Forensic | 9524802-2501 (Utah) | Secondary |
| 103TH0100X | Psychologist - Health Service | 9524802-2501 (Utah) | Secondary |
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | 9524802-2501 (Utah) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 9524802-2501 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Keith Mcgoldrick is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Keith Mcgoldrick, PHD
1733 S 1100 E Ste 102,
Salt Lake City, UT 84105-3482
Ph: (801) 486-6632 | Dr Keith Mcgoldrick, PHD
1733 S 1100 E Ste 102,
Salt Lake City, UT 84105-3482
Ph: (801) 486-6632 |
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