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Individual

WILLIAM BREVARD GOUGER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
755 BETHLEHEM PIKE, STE 2A, MONTGOMERYVILLE, PA 18936
(215) 361-8593
Mailing address
1017 MUELLER RD, WARMINSTER, PA 18974-2775
(215) 443-9073

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000967
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01613276
PA
01
02147
DAVIS VISION
PA
01
501522
BLUE CROSS BLUE SHIELD
PA
Enumeration date
04/21/2006
Last updated
07/08/2007
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