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Organization

WILLIAM D. GOUDY D.O., PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM D. GOUDY DO (CEO)
(260) 927-1982
Entity
Organization

Contact information

Practice address
1306 E 7TH ST, SUITE B, AUBURN, IN 46706-2537
(260) 927-1982
(260) 927-8380
Mailing address
1306 E 7TH ST, SUITE B, AUBURN, IN 46706-2537
(260) 927-1982
(260) 927-8380

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000335961
ANTHEM
IN
05
100103820A
IN
01
DC0427
MEDICARE RAILROAD
IN
Enumeration date
04/23/2007
Last updated
12/28/2009
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