Individual
DR. ALAN R GOULD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
5805 W HIGHWAY 22, CRESTWOOD, KY 40014-7244
(502) 241-7116
(502) 241-2339
Mailing address
1941 BISHOP LN STE 1018, LOUISVILLE, KY 40218-1928
(502) 456-6217
(502) 456-4440
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
12010715A
IN
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
4925
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200022760
—
IN
01
—
2444790000
PASSPORT ADVANTAGE
KY
01
—
6222055
CIGNA HEALTHCARE
—
01
—
P00155545
RAILROAD MEDICARE
—
Enumeration date
08/05/2006
Last updated
02/22/2021
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