Individual
MARK A GOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1524 EUBANK BLVD NE STE 6, ALBUQUERQUE, NM 87112-4160
(505) 503-8806
(888) 503-8511
Mailing address
PO BOX 95590, ALBUQUERQUE, NM 87199-5590
(505) 503-8806
(888) 503-8511
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
PA2005-0029
NM
363A00000X
Physician Assistant
Primary
PA2005-0029
NM
Other
Enumeration date
06/12/2008
Last updated
11/15/2023
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