Individual
DAVID THOMAS GOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1352
(208) 322-1730
(208) 322-1731
Mailing address
2963 E COPPER POINT DR, MERIDIAN, ID 83642-9055
(208) 322-1730
(208) 322-8996
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
O-54
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004311600
—
ID
Enumeration date
05/31/2006
Last updated
01/25/2011
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