# AVON LAKE PODIATRY INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992864490
- **Authorized official:** DR. MARK DAVID GOULD DPM (PRESIDENT)
- **Authorized official phone:** (440) 933-4021

## Contact information

- **Practice address:** 32730 WALKER RD, SUITE I-3, AVON LAKE, OH 44012-4100
- **Practice address phone:** (440) 933-4021
- **Practice address fax:** (440) 933-7132
- **Mailing address:** 32730 WALKER RD, SUITE I-3, AVON LAKE, OH 44012-4100
- **Mailing address phone:** (440) 933-4021
- **Mailing address fax:** (440) 933-7132

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 36.002416 | OH | Yes |

## Other

- **Enumeration date:** 12/08/2006
- **Last updated:** 05/29/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 480004004 | RAILROAD MEDICARE | OH |