Basic Information
| Provider Information | |||||||||
| NPI: | 1154353316 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOPPOLD | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | GOPPOLD | ||||||||
| OtherFirstName: | RONALD | ||||||||
| OtherMiddleName: | WILLIAM | ||||||||
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| OtherCredential: | MD PC | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 95 ALMSHOUSE RD | ||||||||
| Address2: | STE 103 | ||||||||
| City: | RICHBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153575760 | ||||||||
| FaxNumber: | 2155375731 | ||||||||
| Practice Location | |||||||||
| Address1: | 95 ALMSHOUSE RD | ||||||||
| Address2: | STE 103 | ||||||||
| City: | RICHBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153575760 | ||||||||
| FaxNumber: | 2153575731 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 03/07/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD018778E | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.