Organization
HAROLD N GOOCH MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN GUNN (OFFICE MANAGER)
(801) 572-3750
Entity
Organization
Contact information
Practice address
12176 S 1000 E, DRAPER, UT 84020-9716
(801) 572-3750
(801) 572-1097
Mailing address
PO BOX 150610, OGDEN, UT 84415-0610
(801) 476-9200
(801) 476-9208
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
181191-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36972175003001
BLUE CROSS BLUE SHIELD
UT
Enumeration date
05/17/2007
Last updated
12/10/2007
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