Provider Demographics
NPI:1427671619
Name:GOUT, ANTONY (MD)
Entity type:Individual
Prefix:
First Name:ANTONY
Middle Name:
Last Name:GOUT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 PARK ST OFC 530
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1109
Mailing Address - Country:US
Mailing Address - Phone:203-974-7021
Mailing Address - Fax:
Practice Address - Street 1:34 PARK ST OFC 530
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1109
Practice Address - Country:US
Practice Address - Phone:203-974-7021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2025-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-11829207R00000X, 2084P0800X
CT83168207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry