Individual
DR. JUDITH ANN GOULDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
777 RURAL AVE, WILLIAMSPORT, PA 17701-3109
(570) 321-2400
(570) 321-2496
Mailing address
1201 GRAMPIAN BLVD, PO BOX 3127, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
MD019724E
PA
2085N0904X
Nuclear Radiology Physician
MD019724E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007802700001
—
PA
01
—
073898
HIGHMARK BLUE SHIELD
PA
01
—
078201
FIRST PRIORITY HEALTH
PA
01
—
1553604
UNITEDHEALTHCARE
PA
01
—
4501
HEALTHAMERICA
PA
01
—
561809
AETNA
PA
01
—
816713
FIRST PRIORITY HEALTH
PA
Enumeration date
03/08/2006
Last updated
11/30/2007
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