Provider Demographics
NPI:1437876273
Name:GOSS, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GOSS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 FOREST ROAD CIR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73026-0961
Mailing Address - Country:US
Mailing Address - Phone:405-928-6214
Mailing Address - Fax:405-928-6264
Practice Address - Street 1:2301 FOREST ROAD CIR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73026-0961
Practice Address - Country:US
Practice Address - Phone:405-928-6238
Practice Address - Fax:405-928-6264
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor