Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 51489 | TN |
NPI | 1639463011 |
---|---|
Provider Name | Dr. Amanda Marie Goiffon |
First Address | Memphis, TN 38103-3403 |
Second Address | Memphis, TN 38103-3403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2011 |
Last Update Date | 22/03/2017 |