Individual
DR. DALE M GOUGHNOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
713 MOUNTAIN AVE STE 1, PORTAGE, PA 15946-1756
(814) 736-5000
(814) 736-9616
Mailing address
713 MOUNTAIN AVE STE 1, PORTAGE, PA 15946-1756
(814) 736-5000
(814) 736-9616
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC004705L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01847551
—
PA
01
—
043195
UMWA
PA
01
—
304387
UPMC
PA
01
—
480032181
RAILROAD MEDICARE
PA
01
—
GO1304835
HIGHMARK
PW
Enumeration date
11/30/2006
Last updated
06/01/2026
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