Individual
SCOTT C GOGULSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7926 PRESTON HWY STE 106, LOUISVILLE, KY 40219-3848
(502) 964-4357
(502) 966-5948
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(025) 889-4905
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02005420A
IN
207Q00000X
Family Medicine Physician
200501860
NC
207Q00000X
Family Medicine Physician
Primary
53331
KY
207Q00000X
Family Medicine Physician
M7997
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902650
—
NC
Enumeration date
01/27/2006
Last updated
04/13/2023
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