Individual
DR. JAN JACK GOUDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 ELIZABETH PL, SUITE # D, DAYTON, OH 45417-3445
(937) 424-2520
(937) 222-9665
Mailing address
1 ELIZABETH PL, SUITE # D, DAYTON, OH 45417-3445
(937) 424-2520
(937) 222-9665
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
35-072594
OH
208VP0000X
Pain Medicine Physician
Primary
35-072594
OH
Other
Enumeration date
08/21/2006
Last updated
02/23/2026
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