Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | DO0000002737 | TN |
Y | 111NI0900X | Internist | DO0000002737 | TN |
NPI | 1003174350 |
---|---|
Provider Name | Andrew David Goins |
First Address | Knoxville, TN 37923-4308 |
Second Address | Knoxville, TN 37923-4308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2012 |
Last Update Date | 29/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q014509 | (05) | TN |