| Goul Family Medicine Llc | |
|
5128 E Stop 11 Rd Ste 38 Indianapolis IN 46237-6338 | |
| (317) 410-0371 | |
| Not Available |
| Full Name | Goul Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5128 E Stop 11 Rd Ste 38, Indianapolis, Indiana |
| Authorized Official Name and Position | Rhonda Wilson Goul (OWNER) |
| Authorized Official Contact | 3174100371 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Goul Family Medicine Llc 5128 E Stop 11 Rd Ste 38 Indianapolis IN 46237-6338 Ph: (317) 410-0371 | Goul Family Medicine Llc 5128 E Stop 11 Rd Ste 38 Indianapolis IN 46237-6338 Ph: (317) 410-0371 |
| NPI Number | 1386331643 |
|---|---|
| Provider Enumeration Date | 04/18/2023 |
| Last Update Date | 08/22/2023 |
| Medicare PECOS PAC ID | 0143686204 |
|---|---|
| Medicare Enrollment ID | O20230515002497 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386331643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Rhonda Wilson Goul |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023086725 PECOS PAC ID: 5890749287 Enrollment ID: I20050309000248 |
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