Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1508040015 Deactivated / Inactive NPI Male Practitioner

Dr. Willis Manford Gooch , MD

Pediatrics • Fort Duchesne, UT

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Willis Gooch has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 19, 2007
NPI Deactivation Date June 21, 2021
Total Practice Duration ~14 Years of Practice (2007 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Willis Gooch, MD was a registered Pediatrics practicing in Fort Duchesne, UT. Throughout an active medical career spanning 14 years, Dr. Gooch provided care at the practice location at 6822 EAST 1000 SOUTH until profile deactivation on 2021-06-21.

Practice Location & Contact Primary Location

Practice Address

6822 East 1000 South

Fort Duchesne, UT 84026

Telephone 4357256874
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Fort Duchesne, UT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.9 Yrs
Regional Practice Density
1 Specialists

Practicing in Fort Duchesne, UT (688 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License UT 164054-1205

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
NPI 1053319525

Doctor of Optometry

NPI 1063629426

Registered Pharmacist

Delbert Martin , RPH

Pharmacist - Pharmacotherapy

NPI 1073627212

Registered Pharmacist

Dr. Steve Pehrson , MD

Family Medicine

NPI 1164531968

Doctor of Medicine (M.D.)

Bonnie Crozier , PA

Physician Assistant

NPI 1487615134

Physician Assistant

Timothy Mccreary , PA

Physician Assistant

NPI 1487624797

Physician Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated June 21, 2021

Record deactivated on June 21, 2021

NPI Profile Active April 05, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location April 05, 2013

Registered at 6822 EAST 1000 SOUTH, FORT DUCHESNE, UT 84026 (Tel: 4357256874)

📍
Updated Business Mailing Address April 05, 2013

Registered at 6822 EAST 1000 SOUTH, FORT DUCHESNE, UT 84026 (Tel: 4357256874)

👤
Provider Name / Credentials Updated April 05, 2013

Recorded as WILLIS GOOCH, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 05, 2013

Pediatrics (License #164054-1205 in UT)

🟢
Initial NPI Registration & Enumeration December 19, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Willis Gooch. Be the first to share your experience!

Sign in to leave a review for Dr. Willis Gooch

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1508040015
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 19, 2007
Last Update: April 05, 2013
Deactivation Date: June 21, 2021

Mailing Address

6822 East 1000 South

Fort Duchesne, UT 84026

Phone: 4357256874

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.